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Intestinal complications after pelvic exenterations in gynecologic oncology
Dirk Michael Forner1, Björn Lampe
1Kaiserswerther Diakonie, Florence Nightingale Hospital, Duesseldorf, Germany. dr.forner@gmx.de
Summary
Pelvic exenteration surgery carries a moderate risk of intestinal complications, comparable to rectal cancer surgery. A temporary diverting stoma can reduce the clinical impact of anastomotic leakage.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Pelvic Surgery
Background:
- Pelvic exenteration is a radical surgical procedure for advanced pelvic malignancies.
- Intestinal complications, particularly anastomotic leakage, are significant concerns following this surgery.
Purpose of the Study:
- To review the frequency of intestinal complications in patients undergoing pelvic exenteration.
- To evaluate the impact of a temporary diverting stoma on anastomotic leakage.
Main Methods:
- Retrospective review of 90 patients who underwent pelvic exenteration between July 1999 and June 2008.
- Analysis of complication rates, focusing on intestinal issues and anastomotic dehiscence.
- Comparison of leakage rates between patients with and without a protective colostomy.
Main Results:
- Twenty-three percent (25.6%) of patients required surgical intervention for complications.
- Anastomotic dehiscence was the most frequent complication (7.8%), with higher rates in rectal anastomoses (9.5%) than ileal (5.7%).
- Patients with a protective colostomy had a lower, though not statistically significant, risk of symptomatic leakage (4.3% vs. 15.7%).
Conclusions:
- The incidence of intestinal complications after pelvic exenteration is moderate and similar to that seen in rectal cancer surgery.
- Temporary diverting stomas may mitigate the clinical significance of anastomotic leakage in exenterative procedures.
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