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Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
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Curative pelvic exenteration: initial experience and clinical outcome.
Ahmad Ali Uraiqat1, Dania Al Nsour1, Khaled Mohammad Mestareehy1
1Colorectal Unit, King Hussein Medical Center, Royal Medical Services, Amman, Jordan.
The Pan African Medical Journal
|July 17, 2023
Summary
Pelvic exenteration surgery offers over 40% survival for advanced pelvic cancers. Careful patient selection and a multidisciplinary approach are key to reducing complications and improving outcomes in this aggressive treatment.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Advanced primary or recurrent gynecologic, urologic, or rectal cancers without metastatic disease may require extensive surgery like pelvic exenteration for curative treatment.
- Pelvic exenteration is an aggressive surgical procedure reserved for complex pelvic malignancies.
Purpose of the Study:
- To present the initial experience and clinical outcomes of curative pelvic exenteration procedures for advanced or recurrent pelvic cancer.
- To evaluate the feasibility and effectiveness of pelvic exenteration in a specific patient cohort.
Main Methods:
- A retrospective cross-sectional study was conducted from March 2014 to December 2021.
- Included patients who underwent pelvic exenteration for advanced or recurrent pelvic malignancies.
- Analyzed demographic data, procedure types, completeness of excision, and postoperative outcomes (complications, morbidity, mortality).
Main Results:
- Thirty-one operations were performed on 30 patients (22 female, 8 male; median age 55 years).
- The majority of surgeries (26) were for advanced primary malignancies, with 29 for colorectal and 2 for gynecological tumors.
- Complete tumor excision (R0) was achieved in 21 cases; overall complication rate was 67.7%, with 30-day mortality at 16.7%.
- At a median follow-up of 22 months, 33.3% of patients were disease-free.
Conclusions:
- Pelvic exenteration demonstrated an overall survival rate exceeding 40% at a median two-year follow-up.
- Gaining experience, employing a multidisciplinary approach, careful patient selection, and preoperative counseling are crucial for minimizing postoperative morbidity and mortality.
