Pelvic exenteration for advanced primary and recurrent adenocarcinoma.
The authors report on 45 patients who have undergone pelvic exenteration for adenocarcinoma since 1979. Three patients underwent exenteration as the initial treatment for their disease but all others had had previous surgery, radiotherapy or chemotherapy. Operating time and blood loss were lower in previously irradiated patients. There were seven in hospital deaths (15.5%). The number of complications and length of postoperative hospital stay have decreased significantly as experience with pelvic exenteration has been acquired. Symptoms have been controlled in a high proportion of patients. Exenterative surgery is an effective method of treatment in selected patients with pelvic adenocarcinoma but should be undertaken only by experienced surgeons who have access to a wide range of supportive facilities for optimal perioperative management.