Abstract
Total pelvic exenteration was performed in 31 patients (30 males and 1 female) who had rectal cancers involving adjoining pelvic structures. Twenty-nine patients had primary tumors and two had recurrent diseases after previous abdominoperineal resection. Preoperative irradiation was used in nine patients with fixed tumors. When performing the surgical procedure, we also actively employed lateral node dissection to make the operation more radical. Three patients (one with primary tumor and two with recurrent) underwent the exenteration with partial sacrectomy because of the sacral involvement and they all died of local failure within 15 months. The overall 5-year survival rate was 52 percent for all patients and 56 percent for those who had primary tumors. The results suggest that total pelvic exenteration with lateral node dissection should be performed for locally advanced rectal cancer if the tumor is not completely fixed to the pelvic wall and preoperative irradiation should be used to convert a fixed tumor to a resectable one.
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References
Boey J, Wong J, Ong GB. Pelvic exenteration for locally advanced colorectal carcinoma. Ann Surg 1982;195:513–8.
Morson BC, Vaughn EG, Bussey HJ. Pelvic recurrence after excision of rectum for carcinoma. BMJ 1963;2:13–8.
Hughes ES. Results of treatment of carcinoma of colon and rectum. BMJ 1963;2:9–12.
Welch JP, Donaldson GA. The clinical correlation of an autopsy study of recurrent colorectal cancer. Ann Surg 1979;189:496–502.
Orkin BA, Dozois RR, Beart RW Jr, Patterson DE, Gunderson LL, Ilstrup DM. Extended resection for locally advanced primary adenocarcinoma of the rectum. Dis Colon Rectum 1989;32:286–92.
Moriya Y, Hojo K, Sawada T, Koyama Y. Significance of lateral node dissection for advanced rectal carcinoma at or below the peritoneal reflection. Dis Colon Rectum 1989;32:307–15.
Stearns MW Jr. Diagnosis and management of recurrent pelvic malignancy following combined abdominoperineal resection. Dis Colon Rectum 1980:23:359–61.
Welch JP, Donaldson GA. Detection and treatment of recurrent cancer of the colon and rectum. Am J Surg 1978;135:505–10.
Dobrowsky W, Schmid AP. Radiotherapy of presacral recurrence following radical surgery for rectal carcinoma. Dis Colon Rectum 1985;28:917–9.
Touran T, Frost DB, O'Connell TX. Sacral resection: operative technique and outcome. Arch Surg 1990;125:911–3.
Pearlman NW, Stiegmann GV, Donohue RE. Extended resection of fixed rectal cancer. Cancer 1989;63:2438–41.
Duncan W. Preoperative radiotherapy in rectal cancer. World J Surg 1987;11:439–45.
Pilepich MV, Munzenrider JE, Tak WK,et al. Preoperative irradiation of primarily unresectable colorectal carcinoma. Cancer 1978;42:1077–81.
Fortier CA, Constable WC, Meyers H, Wanebo JH. Preoperative radiation therapy for rectal cancer: an effective therapy in need of a clinical trial. Arch Surg 1986;121:1380–4.
Kodner IJ, Shemesh EI, Fry RD, et al. Preoperative irradiation for rectal cancer: improved local control and long-term survival. Ann Surg 1989;209:194–9.
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Liu, S.Y., Wang, Y.N., Zhu, W.Q. et al. Total pelvic exenteration for locally advanced rectal carcinoma. Dis Colon Rectum 37, 172–174 (1994). https://doi.org/10.1007/BF02047542
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DOI: https://doi.org/10.1007/BF02047542