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Muscles of the Pelvic Floor and Perineum01:26

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The muscles of the pelvic floor and perineum are crucial for supporting the pelvic organs, controlling continence, and aiding in sexual function, childbirth, and core stability. They are typically divided into the superficial perineal layer and the deep pelvic floor layer.
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Lateral pelvic compartment excision during pelvic exenteration.

M J Solomon1,2,3,4, K G M Brown1, C E Koh1,2,3

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Radical pelvic exenteration for lateral compartment tumors improved R0 resection rates to 66.5% with a novel technique. This approach offers comparable survival to central tumors, making lateral involvement less of a contraindication.

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Area of Science:

  • Surgical Oncology
  • Pelvic Surgery
  • Cancer Research

Background:

  • Lateral compartment involvement was a contraindication for pelvic exenteration.
  • Initial R0 resection rates were 21%, improving to 53% with a novel technique.
  • This study investigates outcomes of pelvic exenterations involving the lateral compartment.

Purpose of the Study:

  • To report morbidity and oncological outcomes.
  • To evaluate a novel technique for en bloc resection of lateral pelvic structures.
  • To assess the feasibility of pelvic exenteration in cases with lateral compartment involvement.

Main Methods:

  • Review of consecutive patients undergoing pelvic exenteration between 1994 and 2014.
  • Inclusion of 200 patients with en bloc resection of the lateral compartment.
  • Analysis of R0 resection rates, survival data, and predictors of outcome.

Main Results:

  • R0 resection achieved in 66.5% of 197 cancer patients.
  • Clear resection margins significantly improved overall survival in colorectal cancer patients (P=0.030).
  • Median overall survival was 41 months; 5-year survival was 35%.

Conclusions:

  • Evolving radical pelvic exenteration techniques improved R0 rates to 66.5% over 20 years.
  • Adoption of a more lateral anatomical plane enhanced resection success.
  • Five-year survival rates are comparable to those for centrally located tumors.