Pelvic exenteration with rectal resection for different types of malignancies at two tertiary referral centres.

Abstract

INTRODUCTION:

Pelvic exenteration (PE) offers the best chance of cure for locally advanced primary or recurrent pelvic organ malignancies invading adjacent organs. The aims of this study were to analyse results for any pelvic exenteration that includes rectal resection and the analysis of results of fecal and urinary reconstruction.

METHOD:

From January 2000 to April 2014, 111 PE with rectal resection for any pelvic cancer were analysed retrospectively at two national tertiary referral centers.

RESULTS:

Thirty-six colorectal anastomosis were performed. Urologic reconstructions performed were 30 double barrelled wet colostomy (DBWC), 14 Bricker ileal conduit (BIC), and 2 ureterocutaneostomies. Postoperative complications occurred in 71 patients (64%). Six deaths (5.4%) occurred within 30 postoperative days. Five-year overall survival following R0 resection was 62.6%; R1: 42.7%; R2: 24.2% (P=.018). The resection margin status was associated with overall survival, local recurrence and distant recurrence.

CONCLUSION:

Pelvic exenterations for any cause need to be performed in referral centers and by specialized surgeons. Anastomosis after modified supralevator pelvic exenteration for ovarian cancer, is safe. DBWC can be considered a valid option for urologic reconstruction. The most important prognostic factor after pelvic exenteration for malignant pelvic tumors is the status of surgical margins.

• Authors: Alvaro Garcia-Granero, Sebastiano Biondo, Eloy Espin-Basany, Ana González-Castillo, Silvia Valverde, Loris Trenti, Antonio Gil-Moreno, Esther Kreisler
• Journal: Cirugia espanola (Cir Esp (Engl Ed)) Vol. 96 Issue 3 Pg. 138-148 (Mar 2018) ISSN: 2173-5077 [Electronic] Spain
• Vernacular Title: Exenteración pélvica con resección rectal por neoplasias de distinto origen en dos centros de referencia.
• PMID: 29229359 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Topics

• Aged
• Digestive System Surgical Procedures
• Female
• Humans
• Male
• Middle Aged
• Pelvic Exenteration (methods)
• Pelvic Neoplasms (surgery)
• Rectum (surgery)
• Retrospective Studies
• Tertiary Care Centers
• Urologic Surgical Procedures