Total Pelvic Exenteration surgery - Considerations for healthcare professionals

Carvalho, Filipe; Qiu, Shihui; Panagi, Vasia; Hardy, Katy; Tutcher, Hannah; Machado, Marta Rodriguez de Assis; Silva, Francisca; Dinen, Caroline; Lane, Carol; Jonroy, Alleh; Knox, Jon; Worley, Lynn; Whibley, Jessica; Perren, Tobias; Thain, Jane; McPhail, Jacqueline

doi:10.1016/j.ejso.2022.08.011

Cited by 7 publications

(3 citation statements)

References 52 publications

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“…TPE, which removes most or all of the pelvic organs, is the only option for local control and potential cure in locally advanced colon or gynecologic cancers. However, TPE is sometimes offered in a palliative setting including patients with pelvic sepsis or uncontrollable pain due to side effects of intensive radiotherapy or local tumor progression (15). In our study, the included patients belong to both groups with satisfactory perioperative outcomes either by open or laparoscopic approach.…”

Section: Discussionmentioning

confidence: 99%

“…(2) TPE is still associated with a significant risk of morbidity. Therefore, careful planning and case selection are crucial to maximize survival and improve patient quality of life (15). In this sense, a coordinated multidisciplinary team approach can undoubtedly lead to high patient satisfaction and a reduction in short-and long-term morbidities (16).…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Total Pelvic Exenteration Compared to the Open Approach in Advanced Pelvic Malignances

Rodriguez-Ortiz,

Lopez-Cuevas,

Vallejo-Lesmes

et al. 2024

Preprint

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Introduction Total pelvic exenteration (TPE) is a highly complex surgery associated with a high morbidity rate of 40% in reference units. It is performed for advanced or recurrences tumors in the pelvis with infiltration of multiple organs. Sometimes TPE is indicated in situations of palliation due to the side effects of radiotherapy or tumor progression. The aim of our study is to evaluate a single center experience in TPEs using a minimally invasive approach (LTPE) and compare the perioperative outcomes with the open technique (OTPE). Material and methods A prospective study of the TPE carried out in our unit between 2013-2023 was used. All anterior and posterior exenterations were discarded. Perioperative outcomes were evaluated. Results A total of 19 TPEs were analyzed, 9 LTPEs and 10 OTPEs. Most tumors originated from the colon and cervix. Hyperthermic intraperitoneal chemotherapy (HIPEC) was applied in one case of LTPE and intraoperative radiotherapy (IORT) in one case of OTPE. Cases with palliative intent were one in each group. Surgery time was 407 minutes for LTPE and 367 min for OPTE (p=0.38). Length of hospital stay was longer in the OPTE group at 21.6 days vs LTPE with 10.1 days, (p=0.23). The R0 rate excluding palliative cases was 88.9% for LTPE vs. 70% for OPTE (p=0.33). Major morbidity (grade III) was 45% in the LTPE group with no mortality and 40% (grade III/IV) in the OPTE group with one patient dying on admission. Survival was similar in both groups. Conclusion LTPE is a feasible and safe approach with similar perioperative outcomes and a trend toward shorter hospital stay.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Laparoscopic Total Pelvic Exenteration Compared to the Open Approach in Advanced Pelvic Malignances

Rodriguez-Ortiz,

Lopez-Cuevas,

Vallejo-Lesmes

et al. 2024

Preprint

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“…Total pelvic evisceration (TPE) is a surgical intervention aimed at the complete removal of the pelvic organs with the formation of various variants of urine and intestinal discharge (Carvalho et al, 2023). TPE was performed for the first time for bladder cancer by E. M. Bricker in 1940(Bricker & Modlin, 1951.…”

Section: Introductionmentioning

confidence: 99%

External Small Intestine Fistula as a Rare Complication of Total Infralevatory Pelvic Evisceration

Akhtanin¹,

Markov²,

Goev³

et al. 2022

J Biochem Technol

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Due to the improvement of surgical techniques, the number of total pelvic evisceration surgeries is increasing annually. However, the number of postoperative complications remains high and varies between 31.2 and 45.1%. A common complication is the formation of a small intestine fistula. Further postoperative management of patients with the presence of a small intestine fistula is not an easy task. The mortality rate for this complication after total pelvic evisceration reaches 34.4%. The paper presents a clinical case of a patient with an external incomplete unformed small intestine fistula that emerged after performing total infralevatory pelvic evisceration due to local advanced rectal cancer. The article gives a review of the literature data on the problem and a clinical example of the occurrence of complications. The authors provide a detailed description of the patient's medical history. The causes of the fistula and further treatment of the patient, aimed at eliminating the small bowel fistula, are given.

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Quality of Life and Survivorship in Extended Pelvic Resection for Advanced and Recurrent Malignancy

Harji,

Taylor

2024

Coloproctology

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Total Pelvic Exenteration surgery - Considerations for healthcare professionals

Cited by 7 publications

References 52 publications

Laparoscopic Total Pelvic Exenteration Compared to the Open Approach in Advanced Pelvic Malignances

Laparoscopic Total Pelvic Exenteration Compared to the Open Approach in Advanced Pelvic Malignances

External Small Intestine Fistula as a Rare Complication of Total Infralevatory Pelvic Evisceration

Quality of Life and Survivorship in Extended Pelvic Resection for Advanced and Recurrent Malignancy

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