[Total pelvic exenteration. Apropos of 49 cases]

A study of 49 patients operated on in the Caen Oncological Surgical Unit between 1979 and 1987, for cervical (34), uterine (9), rectal (2) or other (4) cancers. The most frequent indication was palliative exenteration after initial treatment, for pain, fistula or hemorrhage. Urinary diversion was either cutaneous, ileal or sigmoidal in equal proportions, the current preference being left iliac colostomy. The originality of this series lies especially in the fact that the pelvic space was replaced by a sigmoid neovagina (21), an omentoplasty and a myoplasty using the internal strap muscles of the thigh. With a mortality rate of 12.2% and a mean five year survival rate of 33%, this would appear to be a valuable procedure for advanced cancer.