Total pelvic exenteration with preservation of fecal continence

Total pelvic exenteration may be required in the management of locally advanced or recurrent pelvic malignancy. Although prolonged survival may be achieved, the morbidity of this procedure is substantial. Many of the complications associated with total pelvic exenteration are related to the perineal wound, the necessity for two cutaneous stomas, and the creation of a empty pelvis that often has been previously irradiated. In selected cases, perineal preservation with restoration of coloanal continuity may significantly reduce postoperative morbidity. We report four cases of recurrent pelvic malignancy treated by total pelvic exenteration with preservation of fecal continence.