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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Outcomes of total pelvic exenteration for colorectal cancer
Minoru Nishio1, Chohei Sakakura, Tomoyuki Nagata
1Department of Surgery and Regenerative Medicine, Division of Surgery and Physiology of the Digestive System, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi, Kamigyo-ku, Kyoto, Japan.
Background/Aims:
Pelvic recurrence occurs in 4-33% of patients who have undergone a curative resection of primary rectal cancer and is thus a serious problem. However, the best treatment for primary rectal cancer remains unclear. In the present study was assessed the outcomes of total pelvic exenteration for colorectal cancer retrospectively.
Methodology:
In the present study was investigated the medical charts of 25 patients who underwent total pelvic exenteration for primary colorectal cancer (n = 12) or postoperative local recurrence of colorectal cancer (n = 13) at the Department of Surgery (Division of Digestive Surgery) of the Kyoto Prefectural University of Medicine between the years 1997-2005.
Results:
The mean disease-free time interval between the first operation for primary colorectal cancer and total pelvic exenteration for the recurrence was 919 days (range, 203-3460 days). Total pelvic exenteration required a mean operation time of 940 minutes (range, 540-1395 minutes). The mean carcinoembryonic antigen (CEA) value was 25.5 ng/ml (range, 1-171.8 ng/ml). Five-year survival was achieved in 9 patients (36%) and inhospital death occurred in 3 patients (12%). The patients with curative resection survived significantly longer than the patients with non-curative resection.
Conclusions:
When curative resection is achieved, total pelvic exenteration for colorectal cancer can result in long-term survival.
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