Management of the pelvic floor after pelvic exenteration

At the Mayo Clinic, 198 exenterative operations were performed from 1950 through 1971. Although the 5-year survival rate of all patients was 33%, bowel obstruction occurred in 11.6% of patients and intestinal fistula formation in 12.6%. The majority of patients with these complications had had previous pelvic irradiation. The difficulty in dealing with the large raw area in the pelvis is discussed with a review of the various methods that have been tried to date to reperitonealize the pelvis and thereby, it is hoped, prevent adhesions or fistula formation.