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Related Experiment Video

Updated: Jun 23, 2026

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer

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Total pelvic exenteration for primary and recurrent malignancies.

F T J Ferenschild1, M Vermaas, C Verhoef

  • 1Department of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands. floferenschild@kpnplanet.nl

World Journal of Surgery
|May 8, 2009
PubMed
Summary

Total pelvic exenteration (TPE) is a complex surgery for advanced pelvic cancers. While associated with significant morbidity, TPE offers good local control and acceptable survival, particularly for rectal and cervical cancers.

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Area of Science:

  • Surgical Oncology
  • Gastrointestinal Surgery
  • Gynecologic Oncology

Background:

  • Complete resection is crucial for prognosis in pelvic tumor surgery.
  • Locally advanced or recurrent pelvic malignancies often require extensive surgical resection.
  • Total pelvic exenteration (TPE) involves en bloc removal of pelvic organs to achieve radical margins.

Purpose of the Study:

  • To evaluate the outcomes of Total Pelvic Exenteration (TPE) for advanced pelvic malignancies.
  • To assess the feasibility, safety, and efficacy of TPE in a diverse patient cohort.

Main Methods:

  • A retrospective analysis of 69 patients who underwent TPE between 1994 and 2008.
  • Patients had various pelvic cancers including rectal, cervical, sarcoma, vaginal, and endometrial.

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  • Neoadjuvant chemotherapy, preoperative radiotherapy, and intraoperative radiotherapy (IORT) were utilized in select cases.

    • Main Results:

    • Median follow-up was 43 months. Surgery involved a median of 448 minutes with significant blood loss and hospitalization.
    • Major and minor complication rates were 34% and 57%, respectively, with a 1% in-hospital mortality.
    • Complete resection (R0) was achieved in 75% of patients. Five-year local control rates varied by cancer type, with primary locally advanced rectal cancer at 89% and recurrent rectal cancer at 38%.

    Conclusions:

    • Total pelvic exenteration (TPE) is a high-morbidity procedure but offers valuable oncological benefits.
    • Good local control and acceptable survival rates justify TPE for selected patients.
    • TPE is particularly beneficial for primary locally advanced rectal cancer and recurrent cervical cancer.