Low colorectal anastomosis and reconstruction after gynecologic cancer

Radical en bloc resection of pelvic tissue remains an important part of the armamentarium of the gynecologic oncologist despite significant advances in radiation oncology and chemotherapy. Total pelvic exenteration can be the only hope of women who have not responded to more conservative therapy. The time has come where it is appropriate to use contemporary techniques in the discipline of reconstructive surgery to restore these women to an acceptable quality of life. It may be the next challenge for the pelvic surgeon to participate in such surgical reconstruction. This challenge is becoming an active part of the oncologic surgical practice in head and neck and breast surgery. This article reviews the techniques that are available in the reconstruction of a functional rectum with elimination of colostomy.