Pelvic Exenteration for the Management of Pelvic Malignancies

Abstract

Pelvic exenteration is a surgical procedure first described by Brunschwig in as a curative or palliative treatment for pelvic and perineal tumors. It is actually a radical operation, involving en bloc resection of pelvic organs, including reproductive structures, bladder, and rectosigmoid. In patients with recurrent cervical and vaginal malignancy, it is associated with a -year survival of more than %. In spite of advances in surgical management, consequences such as stomas, are still frequently unavoidable for radical tumor excision. Most candidates for this procedure have been diagnosed with recurrent cervical cancer that has previously been treated with surgery and radiation, or radiation alone. Complications of pelvic exenteration are more severe than those of standard resection of a colorectal carcinoma, so it is not commonly performed, including wound infection, wound dehiscence also described as burst abdomen the creation of fistulae perineal-fecal, uretero-vaginal, between conduit and perineal wound , urinary tract infections, perineal hernias and intestinal obstruction. Patients need to be carefully selected and counseled about risks and long-term issues related to the surgery. A comprehensive evaluation is required in order to exclude unresectable or metastatic disease. Evolution of the technique through laparoscopy and minimally invasive surgery may result in a reduction of morbidity and mortality.

Современные Взгляды На Хирургический Метод Лечения Местнораспространенного Колоректального Рака С Инвазией В Мочевой Пузырь

“…Эта классификация со-здана и впервые использована для гинекологиче-ских больных, для обозначения комбинированных операций при раке шейки матки. В дальнейшем дан-ная терминология была перенесена в клиническую практику оперативного лечения всех опухолей ма-лого таза [14]. По мнению И. Р. Аглуллина, эвисцера-ции органов малого таза делить на передние и за-дние неправильно, так как эти операции по объему должны относиться к мультивисцеральным вмеша-тельствам.…”