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PubMed1976

Pelvic exenteration.

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Adaptation, Psychological↗
PubMed1989

[Total pelvic exenteration. Apropos of 49 cases].

A study of 49 patients operated on in the Caen Oncological Surgical Unit between 1979 and 1987, for cervical (34), uterine (9), rectal (2) or other (4) cancers. The most frequent indication was palliative exenteration after initial treatment, for pain, fistula or hemorrhage. Urinary diversion was either cutaneous, ileal or sigmoidal in equal proportions, the current preference being left iliac colostomy. The originality of this series lies especially in the fact that the pelvic space was replaced by a sigmoid neovagina (21), an omentoplasty and a myoplasty using the internal strap muscles of the thigh. With a mortality rate of 12.2% and a mean five year survival rate of 33%, this would appear to be a valuable procedure for advanced cancer.

Adult↗
PubMed1989

The morbidity and benefits of concurrent gracilis myocutaneous graft with pelvic exenteration.

This study was undertaken to evaluate the morbidity and potential benefits of concurrent gracilis myocutaneous graft with exenteration. All patients undergoing exenteration from 1962-1986 were reviewed, of whom 24 had concurrent grafts. The mean operative time, blood loss, and hospital stay were not different in patients with versus without grafts. The rate of fistula formation in the hospital was less in the graft group (P = .004) but was not different when compared with contemporary patients only. The total infection rate (wound and pelvic) was decreased in the graft group (P = .04) when graft infections were excluded. The major problem with the graft was significant necrosis of the flap(s) in nine of the 24 patients. There were no life-threatening complications attributed to concurrent placement of gracilis myocutaneous flaps. Experience with the technique is improving the cosmetic and functional outcome of the neovagina formed with the graft. Patients most likely to benefit from this procedure include those requiring immediate reconstruction or those with potentially poor healing due to high-dose pelvic radiation, including intraoperative radiation.

Female↗