[Operative mortality and morbidity in pelvic exenteration. Technical aspects]

Postoperative complications in a continuous series of 23 pelvic exenterations for female genital tumor are analyzed, together with specific technical improvements capable of reducing morbidity and mortality of this major surgery. Emphasis is placed on the use of automatic suturing to improve hemostasis and to facilitate performance of digestive anastomoses. The preferred urinary bypass operation is ureterosigmoidostomy into an excluded loop, cutaneous ureterostomy being reserved for patients in a poor general condition. The only satisfactory procedure for filling of the pelviperineal cavity appears to be internal epiploplasty combined with perineal reconstruction by means of a musculus gracilis flap, which also allows the confection of a new vaginal cavity.