Pelvic exenteration

Pelvic exenteration is an option in cases of very advanced or recurrent cancer, for which less radical surgical options are not technically possible or would not be sufficient to remove all the tumor. This procedure is performed for several types of cancer including genitourinary cancer, and colorectal cancers. It is rarely performed due to common complications. == Contraindications ==

Pelvic exenteration may not cure certain cancers. This can happen if there are metastases in the liver, the sidewall of the pelvic cavity, the aortic lymph nodes, or through carcinosis. In these cases, it may not be used. It may also not be used when both ureters are obstructed. == Complications ==

Between 60% and 90% of all people who have a pelvic exenteration have a complication. Many problems can occur with the stoma. Bowel obstruction may occur, or the anastomosis created by the surgery may leak. The stoma may retract, or may prolapse. Rarely, it may necrose. == Technique ==

Pelvic exenteration involves removal of all of the pelvic organs. Radiology is used before surgery. The surgery itself is complex. == Recovery ==

Pelvic exenteration leaves a person with a permanent colostomy and urinary diversion. A 2015 article reports that pelvic exenteration can provide long-term survival for patients with locally advanced primary rectal carcinoma. The 5-year survival rate of patients undergoing pelvic exenteration following complete resection of disease was 59.3%. Factors shown to influence the survival rate following a pelvic exenteration procedure include age, the presence of metastatic disease, lymph node status, circumferential resection margin, local recurrence of disease, and the need for neoadjuvant therapy. == History ==

The procedure was first described by Alexander Brunschwig in 1948. == References ==