[Pelvic exenteration from the surgical viewpoint]

Pelvic exenteration (PE) is associated with specific problems in the indication of excision and reconstructive surgery. Indication are colorectal cancer or cervical cancer recurrence. In each case intensive and early cooperation of gynecologist, surgeon and urologist is warranted. Thus, PE is indicated in some T3 N1 and T4 rectal carcinoma patients without distant metastases and may be superior to chemotherapy. In cervix carcinoma recurrence, PE with or without intestinal reconstruction is of specific importance. While intestinal reconstruction may improve the quality of life in R0 resected patients we reluctantly perform this in noncurative treated patients, since their expected survival time is limited and reconstructive surgery in these pretreated patients (radiation and surgery) increases the risk of morbidity.