TY - JOUR
T1 - Pelvic exenteration with rectal resection for different types of malignancies at two tertiary referral centres
AU - Kreisler, Esther
AU - Biondo, Sebastiano
AU - Gil-Moreno, Antonio
AU - Espin-Basany, Eloy
AU - Garcia-Granero, Alvaro
AU - González-Castillo, Ana
AU - Valverde, Silvia
AU - Trenti, Loris
PY - 2018/3/1
Y1 - 2018/3/1
N2 - © 2017 AEC 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.
AB - © 2017 AEC 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.
KW - Pelvic exenteration
KW - Colorectal anastomosis
KW - Double barrelled wet colostomy
UR - https://dialnet.unirioja.es/servlet/articulo?codigo=6341677
U2 - 10.1016/j.ciresp.2017.11.001
DO - 10.1016/j.ciresp.2017.11.001
M3 - Article
SN - 0009-739X
VL - 96
SP - 138
EP - 148
JO - Cirugia Espanola
JF - Cirugia Espanola
IS - 3
ER -