Pelvic Exenteration With Rectal Resection for Different Types of Malignancies at Two Tertiary Referral Centers

García-Granero, Álvaro; Biondo, Sebastiano; Espín‐Basany, Eloy; González-Castillo, Ana María; Valverde, Silvia; Trenti, Loris; Kreisler, Esther

doi:10.1016/j.cireng.2018.02.002

Cited by 6 publications

(10 citation statements)

References 30 publications

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“…PE is a complex treatment procedure that involves high postoperative risks but also has late functional and psychological consequences for patients. Appropriate indications include locally advanced primary or recurrent tumours . Accurate patient selection, modern preoperative staging, along with advances in surgical techniques and perioperative patient care have led to increased survival rates in recent years.…”

Section: Discussionmentioning

confidence: 99%

“…Accurate patient selection, modern preoperative staging, along with advances in surgical techniques and perioperative patient care have led to increased survival rates in recent years. Regardless of the histological type, R0 resection remains the main prognostic factor . PE has been associated with up to 100% postoperative morbidity rates and up to 25% mortality in the past .…”

Section: Discussionmentioning

confidence: 99%

“…PE has been associated with up to 100% postoperative morbidity rates and up to 25% mortality in the past . Even though the mortality has been reduced today (0%–6%) morbidity still remains high (34%–80%) . Most surgical complications in PE are due to the remaining dead space following pelvic organ excision, known as the so‐called empty pelvis syndrome .…”

Section: Discussionmentioning

confidence: 99%

“…Pelvic exenteration (PE) represents the only potentially curative treatment for locally advanced or recurrent rectal, bladder and gynaecological cancers . The term PE involves different types of procedures of en bloc resection of internal pelvic organs, depending on the patient's gender.…”

Section: Introductionmentioning

confidence: 99%

“…The most recent mortality and morbidity rates reported were 0%–6% and 34%–80%, respectively . One of the major causes of postoperative complications is empty pelvis syndrome, including abscess formation, bowel obstruction, perforation and enterocutaneous fistulas resulting from the residual dead space.…”

Section: Introductionmentioning

confidence: 99%

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Empty pelvis syndrome: the use of breast prosthesis in the prevention of complications

et al. 2019

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Aim Empty pelvis syndrome and radiation‐induced bowel injury are two major clinical issues resulting from the pelvic dead space after pelvic exenteration (PE). In order to avoid these complications, different methods of pelvic floor reconstruction have been proposed. We report our experience on the use of breast prosthesis. Method Fifty‐three patients who underwent PE and three who underwent palliative surgery with silicone breast prosthesis placement were included. Results Forty‐seven posterior PE, six total PE and three palliative procedures were identified. Sphincter preservation was feasible in 34 patients (62.3%). There were no deaths. Overall morbidity was 37.5%. There were no complications such as sepsis or obstruction related to the prosthesis. Adjuvant radiotherapy was delivered in 16 cases (30.1%) without any side‐effects. Reconstruction of intestinal continuity was possible in 12 patients (36.3%) with sphincter preservation and the prosthesis allowed a prompt identification of the rectal stump. Conclusion Breast prosthesis placement is a simple and safe method to minimize complications resulting from empty pelvis syndrome and can be adopted to exclude bowel loops from the radiation field. Reconstruction of intestinal continuity after resection is also simplified.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%