The global cost of pelvic exenteration: in-hospital perioperative costs

Kelly, Michael E.; AGJ, Aalbers; Aziz, Nauman; Abecasis, Nuno; Abraham-Nordling, Mirna; Akiyoshi, Takashi; Alberda, Wijnand J.; Albert, Matthew L.; Andric, Mihailo; Angenete, Eva; Antoniou, A; Auer, R; Austin, Kirk K. S.; Aziz, Omer; Baker, R. P.; Bali, M; Baseckas, Gediminas; Bebington, Brendan; Bedford, Matthew; Bednarski, Brian Keith; Beets, Geerard L.; Berg, P L; Beynon, J; Biondo, Sebastiano; Boyle, K.; Bordeianou, L; Bremers, A B; Brunner, Markus; Buchwald, Pamela; Bui, Ai-Tram N.; Burgess, Andrea; Jwa, Burger; Burling, D; Burns, E.; Campain, Nicholas; Carvalhal, Sara; Castro, Luis M.; Caycedo‐Marulanda, Antonio; Chan, Kkl; Chang, George J.; Chang, Matthew Wook; Chew, Min Hoe; Chok, A. K.; Chong, Peter Siao Tick; Christensen, Henrik; Clouston, H; Codd, Mary; Collins, Danielle; Colquhoun, A J; Corr, Alison; Coscia, Maurizio; Cosimelli, Maurizio; Coyne, Peter; Croner, Roland S.; Damjanovic, L; Daniels, Ian R.; Davies, Mark; Davies, Richard J.; Delaney, Clare; Jhw, Wilt; Denost, Quentin; Deutsch, C; Dietz, D.; Domingo, Sebastián; Dozois, Eric J.; Duff, M. J.; Eglinton, Tim; Enrique-Navascues, J M; Espín‐Basany, Eloy; Evans, Martyn; Eyjólfsdóttir, Brynhildur; Fahy, Matthew; Fearnhead, Nicola; Flatmark, Kjersti; Fleming, Fergal J.; Folkesson, Joakim; Frizelle, Frank; Gallego, Mario Álvarez; García‐Granero, Eduardo; García-Sabrido, J.L.; Gentilini, Lorenzo; George, Mark; George, Vijay; Ghouti, Laurent; Giner, Francisco; Ginther, N; Glynn, R; Golda, Thomas; Griffiths, Ben; Harris, DA; JAW, Hagemans; Hanchanale, Vishwanath; Harji, Deena; Helewa, Ramzi M.; Hellawell, Giles; Heriot, Alexander G.; Hochman, David; Hohenberger, Werner; Holm, T.; Hompes, Roel; Jenkins, Jordan; Kaffenberger, Samuel D.; Kandaswamy, G V; Kapur, Sandeep; Kanemitsu, Yukihide; Kelley, S R; Keller, Deborah S.; Khan, Mohiuddeen; Kim, H.; Kim, H. J.; Koh, Christopher; Nfm, Kok; Kokelaar, R; Kontovounisios, Christos; Kristensen, Helle; Kroon, Hidde M.; Kumar, Sudesh; Kusters, Miranda; Lago, Vanessa Carvalho do; Lakkis, Zaher; Larsen, Stein Gunnar; Larson, D W; Law, WL; Laurberg, Søren; Lee, P. J.; Limbert, M; Lydrup, Marie Louise; Lyons, Arnold R.; Lynch, A. C.; Mantyh, Christopher R.; Mathis, Kellie L.; Cfs, Margues; Martling, Anna; WJHJ, Meijerink; Merchea, Amit; Merkel, Susanne; Mehta, A M; McArthur, D. Ray; McDermott, Frank; McGrath, J. S.; Malde, Sachin; Mirnezami, A.; Monson, J. R. T.; Morton, Jasmine; Mullaney, Tamara G.; Negoi, Ionuț; Jwm, Neto; Ng, Jmk; Nguyen, Binh P.; Nielsen, M. B.; Gap, Nieuwenhuijzen; Nilsson, Per J.; Oliver, Alex; O’Dwyer, S T; Palmer, Geraint; Pappou, Emmanouil P.; Park, J.; Patsouras, Dimitrios; Pellino, Gianluca; Peterson, Alexandra; Poggioli, Gilberto; Proud, David; Quinn, Martha; Quyn, Aaron; Rajendran, Nirooshun; Radwan, Rami; Rasheed, Shahnawaz; Rasmussen, P.; Rausa, Emanuele; Regenbogen, S E; Renehan, Andrew G; Rocha, Rafael Ramos da; Rochester, Mark; Rohila, Jitender; Rothbarth, Joost; Rottoli, Matteo; Roxburgh, C; Hjt, Rutten; Safar, Bashar; Sagar, Pallavi; Sahai, Amit; Saklani, Avanish; Sammour, Tarik; Sayyed, Rameez; AMP, Schizas; Schwarzkopf, Eugenia; Scripcariu, Viorel; Selvasekar, Chelliah; Shaikh, I.; Shida, Dai; Simpson, A.; Skeie-Jensen, Tone; Smart, Neil; Smart, Philip; Smith, Julia; Solbakken, Arne M.; Solomon, Michael J.; Sørensen, Mette Møller; Steele, Scott R.; Steffens, Daniel; Stitzenberg, Karyn B.; Stocchi, Luca; Stylianides, N; Swartling, Torbjörn; Sumrien, H; Sutton, Paul; Swartking, T; Tan, Eric J.; Taylor, Claire; Tekkis, Paris; Teras, J; Thurairaja, Ramesh; Toh, Ee‐Lin; Tsarkov, Petr; Tsukada, Yuichiro; Tsukamoto, Shunsuke; Tuech, J J; Turner, William H.; Tuynman, Jurriaan B.; Ramshorst, Gabriëlle H. van; Zoggel, D van; Vásquez-Jiménez, W; Verhoef, Cornelis; Vizzielli, Giuseppe; ELK, Voogt; Uehara, Kay; Wakeman, Chris; Warrier, Satish; Wasmuth, Hans H.; Weber, K; Weiser, Martin R.; Jmd., Wheeler; Wild, Jeremy; Wilson, Margaret; Wolthuis, Albert; Yano, H; Yip, Benjamin Cherng Hann; Yip, Jeremy; Yoo, Ri Na; Zappa, Marco; Winter, Desmond C.

doi:10.1002/bjs.11924

Cited by 2 publications

(2 citation statements)

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“…There was an association between side-wall resection and flap reconstruction. Using data previously compiled by the PelvEx Collaborative, the cost of performing a PE is approximated to range from US$13,230 to US$43,950, though this does not include the cost of reintervention for postoperative complications [26]. As well as the financial implications, this paper highlights the importance of careful perioperative planning and optimization, including prehabilitation which 58% of patients underwent, and a multidisciplinary surgical sub-specialty approach with urological, plastic and gynaecological surgeons as needed.…”

Section: Discussionmentioning

confidence: 99%

Evaluating postoperative hernia incidence and risk factors following pelvic exenteration

Milanko,

Kelly,

Turner

et al. 2024

Int J Colorectal Dis

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Pelvic exenteration (PE) is a technically challenging surgical procedure. More recently, quality of life and survivorship following PEs are being increasingly acknowledged as important patient outcomes. This includes evaluating major long-term complications such as hernias, defined as the protrusion of internal organs through a facial defect (The PelvEx Collaborative in Br J Surg 109:1251–1263, 2022), for which there is currently limited literature. The aim of this paper is to ascertain the incidence and risk factors for postoperative hernia formation among our PE cohort managed at a quaternary centre. Method A retrospective cohort study examining hernia formation following PE for locally advanced rectal carcinoma and locally recurrent rectal carcinoma between June 2010 and August 2022 at a quaternary cancer centre was performed. Baseline data evaluating patient characteristics, surgical techniques and outcomes was collated among a PE cohort of 243 patients. Postoperative hernia incidence was evaluated via independent radiological screening and clinical examination. Results A total of 79 patients (32.5%) were identified as having developed a hernia. Expectantly, those undergoing flap reconstruction had a lower incidence of postoperative hernias. Of the 79 patients who developed postoperative hernias, 16.5% reported symptoms with the most common symptom reported being pain. Reintervention was required in 18 patients (23%), all of which were operative. Conclusion This study found over one-third of PE patients developed a hernia postoperatively. This paper highlights the importance of careful perioperative planning and optimization of patients to minimize morbidity.

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Section: Discussionmentioning

confidence: 99%

Evaluating postoperative hernia incidence and risk factors following pelvic exenteration

Milanko,

Kelly,

Turner

et al. 2024

Int J Colorectal Dis

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show abstract

“…A multidisciplinary team approach is essential to optimise patients pre-operatively and during their recovery process [ 5 ]. More recently, there has been a move to centralize care to specialized units, as this facilitates a better integration of prehabilitation protocols, subspecialty involvement and a greater emphasis on research and quality of life assessments [ 5 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Contemporary Management of Locally Advanced and Recurrent Rectal Cancer: Views from the PelvEx Collaborative

Collaborative¹

2022

Cancers

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Pelvic exenteration is a complex operation performed for locally advanced and recurrent pelvic cancers. The goal of surgery is to achieve clear margins, therefore identifying adjacent or involved organs, bone, muscle, nerves and/or vascular structures that may need resection. While these extensive resections are potentially curative, they can be associated with substantial morbidity. Recently, there has been a move to centralize care to specialized units, as this facilitates better multidisciplinary care input. Advancements in pelvic oncology and surgical innovation have redefined the boundaries of pelvic exenterative surgery. Combined with improved neoadjuvant therapies, advances in diagnostics, and better reconstructive techniques have provided quicker recovery and better quality of life outcomes, with improved survival This article provides highlights of the current management of advanced pelvic cancers in terms of surgical strategy and potential future developments.

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The global cost of pelvic exenteration: in-hospital perioperative costs

Cited by 2 publications

References 7 publications

Evaluating postoperative hernia incidence and risk factors following pelvic exenteration

Evaluating postoperative hernia incidence and risk factors following pelvic exenteration

Contemporary Management of Locally Advanced and Recurrent Rectal Cancer: Views from the PelvEx Collaborative

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