Composite Pelvic Resection

Wanebo, Harold J.; Whitehill, Richard; Gaker, Douglas L.; Wang, Gwo J.; Morgan, Raymond F.; Constable, William C.

doi:10.1001/archsurg.1987.01400240047008

Cited by 34 publications

(5 citation statements)

References 11 publications

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“…Zahlreiche Arbeiten belegen, dass selbst bei muskuloskelettaler Infiltration -jedoch ohne Fernmetastasen oder Peritonealkarzinomatose -eine R0-Resektion bei kolorektalen Lokalrezidiven unter Mitnahme knöcherner Beckenringanteile möglich und für den Patienten gewinnbringend ist [13,16,18,19,20,21]. In Einzelfällen zur palliativen Therapie eingesetzt, kann die Exenteratio pelvis auch hier zur erheblichen Verbesserung der Lebensqualität führen (Debulking-Operation [4,13]).…”

Section: Indikationen Zur Exenteratio Pelvisunclassified

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Mikrochirurgische Beckenbodenrekonstruktion nach Exenteratio pelvis

Stechl

Baumeister

Grimm

et al. 2010

Chirurg

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The present two-stage concept of pelvic floor reconstruction with free latissimus dorsi muscle flaps for wound closure after pelvic exenteration improves postoperative morbidity and mortality and increases the quality of life of the affected patients. A shortened period of open wound therapy brings additional economic benefits. Because of its anatomical features the free latissimus dorsi flap can be regarded as the method of choice of microsurgical reconstruction within an interdisciplinary concept after pelvic exenteration.

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Section: Indikationen Zur Exenteratio Pelvisunclassified

“…Hauptproblem ist hier der komplexe Beckenbodenverschluss nach expansiver Eviszeration [18,19,20,21].…”

Section: Rekonstruktionsziele Nach Exenteratio Pelvisunclassified

Mikrochirurgische Beckenbodenrekonstruktion nach Exenteratio pelvis

Stechl

Baumeister

Grimm

et al. 2010

Chirurg

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“…Limb salvage surgery of the pelvis (internal hemipelvectomy) is now accepted and is generally applied to primary bone and soft tissue tumors arising in the pelvis [24,[34][35][36]. Carefully selected patients with visceral tumors that invade the bony pelvis may now benefit from resection and salvage of the extremity as well [37][38][39][40][41].…”

Section: Surgerymentioning

confidence: 99%

Sarcoma and metastatic carcinoma

Wolf

2000

J. Surg. Oncol.

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“…Wanebo et al reported eight limited resections of the bony pelvis (five involving ileum or ischium, and three involving pubic rami or symphysis) as part of a larger mixed cohort of LARC and LRRC, of which four patients survived a minimum of 3 years. 81 Lopez and Luna-Pérez reported a mixed cohort of 34 pelvic tumors (including rectal, gynecological, urological, and sarcoma) involving the bony pelvis, achieving an R0 resection rate of 88% and a cancer-specific 5-year survival of 52%. 82 Despite the heterogeneity of patients and procedures in these two studies, the overriding principle that an R0 resection is the most significant factor in predicting survival is maintained and that composite pelvic resections are feasible for a limited number of patients.…”

Section: Introductionmentioning

confidence: 99%

Locally advanced rectal cancer: management challenges

Kokelaar¹,

Evans²,

Davies³

et al. 2016

OTT

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Between 5% and 10% of patients with rectal cancer present with locally advanced rectal cancer (LARC), and 10% of rectal cancers recur after surgery, of which half are limited to locoregional disease only (locally recurrent rectal cancer). Exenterative surgery offers the best long-term outcomes for patients with LARC and locally recurrent rectal cancer so long as a complete (R0) resection is achieved. Accurate preoperative multimodal staging is crucial in assessing the potential operability of advanced rectal tumors, and resectability may be enhanced with neoadjuvant therapies. Unfortunately, surgical options are limited when the tumor involves the lateral pelvic sidewall or high sacrum due to the technical challenges of achieving histological clearance, and must be balanced against the high morbidity associated with resection of the bony pelvis and significant lymphovascular structures. This group of patients is usually treated palliatively and subsequently survival is poor, which has led surgeons to seek innovative new solutions, as well as revisit previously discarded radical approaches. A small number of centers are pioneering new techniques for resection of beyond-total mesorectal excision tumors, including en bloc resections of the sciatic notch and composite resections of the first two sacral vertebrae. Despite limited experience, these new techniques offer the potential for radical treatment of previously inoperable tumors. This narrative review sets out the challenges facing the management of LARCs and discusses evolving management options.

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Composite Pelvic Resection

Cited by 34 publications

References 11 publications

Mikrochirurgische Beckenbodenrekonstruktion nach Exenteratio pelvis

Mikrochirurgische Beckenbodenrekonstruktion nach Exenteratio pelvis

Sarcoma and metastatic carcinoma

Locally advanced rectal cancer: management challenges

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