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[Laparoscopic anterior pelvic exenteration in a patient with locally advanced melanoma]
David Isla-Ortiz1, Gonzalo Montalvo-Esquivel1, Roberto Eduardo Herrera-Goepfert2
1Servicio de Ginecología Oncológica, Instituto Nacional de Cancerología, Ciudad de México, México.
Background:
Pelvic exenteration is one of the most mutilating surgical procedures with high post-operative morbidity. The laparoscopic technique aims to reduce perioperative complications and reduce post-surgical recovery.
Objective:
We present the first case of laparoscopic anterior exenteration for locally advanced melanoma, held at the National Cancer Institute and published in Mexico.
Case Report:
Patient 60 years of age diagnosed with invasive vulvar melanoma with bladder extension upon whom laparoscopic anterior pelvic exenteration with external urinary reconstruction was performed. Time in surgery was 505minutes and estimated blood loss was 400ml. No complications occurred during or immediately after surgery. The final histopathological study reported: nodular lesion that completely replaces the clitoris and spreads to the left labia majora, measures 3×2.5×2cm and is located relative to the free margins with perineural invasion intraepithelial spread in space and urethra and bladder trigone.
Conclusions:
The laparoscopic anterior pelvic exenteration is a safe alternative in well-selected patients, with acceptable time in surgery, surgical complications and recovery time.
