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Exenterative operations: experience with 198 patients.

R E Symmonds, J H Pratt, M J Webb

    American Journal of Obstetrics and Gynecology
    |April 1, 1975
    PubMed
    Summary
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    Pelvic exenteration surgery offers a 33% 5-year survival rate for advanced pelvic malignancies, even for recurrent cases. Improved surgical techniques and patient management have significantly reduced operative mortality.

    Area of Science:

    • Oncology
    • Surgical Oncology
    • Pelvic Surgery

    Background:

    • Pelvic exenteration is a radical surgical procedure for advanced pelvic malignancies.
    • Historically, high morbidity and mortality rates have limited its application.
    • Managing recurrent pelvic cancers often presents significant therapeutic challenges.

    Purpose of the Study:

    • To evaluate the survival outcomes and complication rates of pelvic exenteration.
    • To assess the impact of improved surgical and supportive care on patient outcomes.
    • To identify patient populations who may benefit from exenterative procedures.

    Main Methods:

    • Retrospective analysis of 198 pelvic exenterative operations performed at the Mayo Clinic.
    • Review of patient data including diagnosis, surgical approach, complications, and survival.

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  • Comparison of outcomes between different time periods to assess improvements in care.

    • Main Results:

    • A 5-year survival rate of 33% was achieved in 198 patients undergoing pelvic exenteration.
    • Operations for recurrent malignancy constituted nearly 80% of the cases.
    • Operative mortality decreased from 13.5% (1950-1962) to 3% (1963-1971).
    • Improvements in urinary diversion, fluid management, and infection control contributed to reduced mortality.

    Conclusions:

    • Pelvic exenteration can achieve commendable survival rates, particularly for recurrent pelvic cancers.
    • Advances in surgical techniques and perioperative management have significantly improved safety and outcomes.
    • Exenteration should be considered for patients with pelvic malignancy when conservative therapies fail.