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Exenteration pelvic surgery

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https://www.readbyqxmd.com/read/28594725/pelvic-exenteration-surgery-the-evolution-of-radical-surgical-techniques-for-advanced-and-recurrent-pelvic-malignancy
#1
Kilian G M Brown, Michael J Solomon, Cherry E Koh
Pelvic exenteration was first described by Alexander Brunschwig in 1948 in New York as a palliative procedure for recurrent carcinoma of the cervix. Because of initially high rates of morbidity and mortality, the practice of this ultraradical operation was largely confined to a small number of American centers for most of the 20 century. The post-World War II era saw advances in anaesthesia, blood transfusion, and intensive care medicine that would facilitate the evolution of more radical and heroic abdominal and pelvic surgery...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28585317/modified-posterior-pelvic-exenteration-for-advanced-ovarian-malignancies-a-single-institution-study-of-35-cases
#2
Lubos Minar, Michal Felsinger, Ivo Rovny, Filip Zlamal, Julie Bienertova-Vasku, Eva Jandakova
INTRODUCTION: This study aimed to investigate the possible benefits of a complete cytoreduction in patients with advanced ovarian cancer and concomitant rectal invasion. Furthermore, we evaluated the morbidity associated with radical surgery. MATERIAL AND METHODS: A retrospective analysis examined 35 cases that underwent radical surgery in the form of modified posterior pelvic exenteration (MPPE). Descriptive statistics, Kaplan-Meier survival curves and Log-Rank test were used for statistical estimations...
June 6, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28576262/total-laparoscopic-pelvic-exenteration-for-a-laterally-recurrent-cervical-carcinoma-with-a-vesicovaginal-fistula-that-developed-after-concurrent-chemoradiotherapy
#3
Hiroyuki Kanao, Yoichi Aoki, Tsuyoshi Hisa, Nobuhiro Takeshima
OBJECTIVE: For locally advanced cervical carcinoma, concurrent chemoradiotherapy (CCRT) is the standard treatment, however, CCRT can lead to development of a vesicovaginal or rectovaginal fistula [1]. Treatment options are limited for patients with laterally recurrent cervical carcinoma and fistula formation after CCRT. Chemotherapy with bevacizumab is now used for recurrent or advanced cervical carcinoma, but this treatment is associated with fistula formation [2]. When the recurrent mass is confined to the pelvic cavity, complete surgical resection with negative margins offers the most promise; however, the resectability rate is low in cases of laterally recurrent tumor [3], which may include bony structures, and survival outcomes seem to be poor in cases of a laterally recurrent vs...
May 30, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28567186/critical-evaluation-of-contemporary-management-in-a-new-pelvic-exenteration-unit-the-first-25-consecutive-cases
#4
Min Hoe Chew, Yu-Ting Yeh, Ee-Lin Toh, Stephen Aditya Sumarli, Ghee Kheng Chew, Lui Shiong Lee, Mann Hong Tan, Tiffany Priyanthi Hennedige, Shin Yi Ng, Say Kiat Lee, Tze Tec Chong, Hairil Rizal Abdullah, Terence Lin Hon Goh, Mohamed Zulfikar Rasheed, Kok Chai Tan, Choong Leong Tang
AIM: To critically appraise short-term outcomes in patients treated in a new Pelvic Exenteration (PE) Unit. METHODS: This retrospective observational study was conducted by analysing prospectively collected data for the first 25 patients (16 males, 9 females) who underwent PE for advanced pelvic tumours in our PE Unit between January 2012 and October 2016. Data evaluated included age, co-morbidities, American Society of Anesthesiologists (ASA) score, Eastern Cooperative Oncology Group (ECOG) status, preoperative adjuvant treatment, intra-operative blood loss, procedural duration, perioperative adverse event, lengths of intensive care unit (ICU) stay and hospital stay, and oncological outcome...
May 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28550641/a-fascia-lata-free-flap-in-pelvic-exenteration-for-fournier-gangrene-due-to-advanced-rectal-cancer-a-case-report
#5
Hiroshi Sawayama, Nobutomo Miyanari, Hidetaka Sugihara, Shiro Iwagami, Takao Mizumoto, Tatsuo Kubota, Yoshio Haga, Hideo Baba
BACKGROUND: Fournier gangrene due to advanced rectal cancer is a rapidly progressive gangrene of the perineum and buttocks. Emergency surgical debridement of necrotic tissue is crucial, and secondary surgery to resect tumors is necessary for wound healing. However, pelvic exenteration damages the pelvic floor, increasing the likelihood of herniation of internal organs into the infectious wound. The management of pelvic exenteration for rectal cancer with Fournier gangrene has not yet been established...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28546709/salvage-surgery-for-cervical-cancer-recurrences
#6
P Rema, Arun Peter Mathew, S Suchetha, Iqbal Ahmed
Cervical cancer usually presents in advanced stages and is treated with chemoradiation. About 15-20 % patients present with local recurrence after chemoradiation. Radical surgical resection is the only treatment modality offering long term survival benefit in recurrent cervical cancer. The most common surgical option for these patients is pelvic exenteration. Radical hysterectomy may be done for patients with a small centrally located recurrence in the cervix with no infiltration of adjacent structures. The aim of this study was to evaluate the morbidity and survival outcome following radical hysterectomy and pelvic exenteration for recurrent cancer cervix...
June 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28537698/synthetic-mesh-repair-of-an-anterior-perineal-hernia-following-robotic-radical-urethrocystectomy
#7
Horacio J Alvarez Garzón, Thomas Maubon, Camille Jauffret, Pierre Vieille, Brigitte Fatton, Renaud de Tayrac
INTRODUCTION: Perineal hernia is a protrusion of intra-abdominal viscera through a defect in the pelvic floor and is a rare but challenging complication after extensive abdominoperineal surgery. There have been small series published after colorectal exenteration, but no cases have been reported after radical cystectomy and urethrectomy. CASE PRESENTATION: A 68 years old woman developed an anterior perineal hernia, with no vaginal prolapse, after an anterior exenteration for bladder cancer...
May 23, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28529192/short-and-long-term-outcomes-following-pelvic-exenteration-for-gynae-oncological-and-colorectal-cancers-a-9-year-consecutive-single-centre-cohort-study
#8
Mark Katory, Ross McLean, Edgar Paez, Ali Kucukmetin, Raj Naik
OBJECTIVES: Radical pelvic exenteration can be undertaken for locally invasive or recurrent disease in both colorectal and gynaecological malignancies. In the UK this procedure is usually undertaken by the respective surgical specialties who have undergone divergent surgical training. This study describes and compares outcomes between colorectal and gynae-oncological teams following pelvic exenteration for primary and recurrent gynaecological and colorectal cancers in a single-centre multi-disciplinary team...
May 19, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28528932/robot-assisted-gynaecological-cancer-surgery-complications-and-prevention
#9
REVIEW
Ka Yu Tse, Hextan Yuen Sheung Ngan, Peter Christopher Lim
Ever since the US Food and Drug Administration approval of the use of da Vinci surgical systems (Intuitive Surgical Inc., Sunnyvale, California) in gynaecology in 2005, robot-assisted surgery has been widely adopted in different countries. Some of the applications in benign and oncological gynaecology include myomectomy, sacrocolpopexy, tubal anastomosis, simple hysterectomy, radical hysterectomy, radical trachelectomy, pelvic and/or para-aortic lymphadenectomy and even debulking surgery for ovarian cancer and pelvic exenteration for recurrent cervical and vaginal cancer...
April 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28498727/good-prognosis-went-badly-fulminant-evolution-of-a-29-year-old-patient-with-verrucous-carcinoma-of-the-cervix
#10
Rodica M Anghel, Oana G Trifanescu, Radu I Mitrica, Fabiana G Curea, Inga Botnariuc, Catalin G Herghelegiu, Cristina M Orlov, Silvia M Ilie
Verrucous carcinoma (VC) is a very rare variant of squamous cell carcinoma of the cervix, difficult to point out in histology because of its benign appearance. We present the case of a 29-year-old woman with a locally advanced cervical VC who underwent radiotherapy followed by radical hysterectomy. After local relapse and despite pelvic exenteration, her condition deteriorated. Treatment of choice in VC is surgery, because of the risk of anaplastic transformation under irradiation, raising the chances of distant spread and converting this rather benign-like type of cancer to an aggressive cancer...
May 12, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28498240/simple-vaginal-trachelectomy-a-valuable-fertility-preserving-option-in-early-stage-cervical-cancer
#11
Marie Plante, Marie-Claude Renaud, Alexandra Sebastianelli, Jean Gregoire
OBJECTIVE: Radical trachelectomy is a valid alternative for the treatment of early-stage cervical cancer in young women who wish to preserve fertility potential. Recent data indicate that even less radical surgery could be performed in low-risk cases. The objective of our study was to evaluate the safety of simple vaginal trachelectomy and node assessment in patients with low-risk, early-stage cervical cancer (<2 cm). METHODS: From May 2007 to July 2016, 35 women underwent a simple vaginal trachelectomy with laparoscopic sentinel lymph node mapping + pelvic node dissection...
June 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28255734/robot-assisted-laparoscopic-transperitoneal-infrarenal-lymphadenectomy-in-patients-with-locally-advanced-cervical-cancer-by-single-docking-do-we-need-a-backup-procedure
#12
Fatih Gucer, Selim Misirlioglu, Nuri Ceydeli, Cagatay Taskiran
To present our initial experience on the feasibility of robotic transperitoneal para-aortic lymphadenectomy up to left renal vein via single docking approach by high port insertion technique followed by left shoulder docking as a rescue backup procedure in surgically obstructed patients undergoing surgical staging because of locally advanced cervical cancer (LACC). Prospective observational preliminary study. Canadian Task Force classification II-3. Tertiary-care academic affiliated private hospital. Ten patients with LACC who underwent robotic transperitoneal infrarenal para-aortic lymphadenectomy between January 2012 and December 2014...
March 2, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28133349/-long-term-survival-of-a-patient-with-sigmoid-colon-cancer-with-multiple-visceral-metastases
#13
Yoshiyuki Sasaki, Naoto Nishigori, Fumikazu Koyama, Takeshi Ueda, Takashi Inoue, Keijirou Kawasaki, Shinsaku Obara, Takayuki Nakamoto, Yasuyuki Nakamura, Hisao Fujii, Yoshiyuki Nakajima
A 66-year-old woman underwent total pelvic exenteration for a pelvic tumor. The pathological diagnosis was sigmoid colon cancer T4b(in the small intestine, uterus, and vagina), N0, M0, Stage II . The patient was treated with XELOX for 6 months as adjuvant chemotherapy and was then treated with IRIS for another 6 months. Brain metastasis developed in the left occipital lobe after 12 months, and she underwent craniotomy and enucleation of the tumor. Liver metastasis and peritoneal dissemination metastasis developed 16 months after her initial diagnosis...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28130592/extended-lymphadenectomy-for-locally-advanced-and-recurrent-rectal-cancer
#14
Panagiotis A Georgiou, S Mohammed Ali, Gina Brown, Shahnawaz Rasheed, Paris P Tekkis
PURPOSE: The purpose of this study is to assess the value of extended (lateral) lymphadenectomy (EL) in the operative management of locally advanced and recurrent rectal cancer. METHODS: Patients that underwent exenterative surgery for locally advanced or recurrent rectal cancer between 2006 and 2009 were included in the study. A decision for EL was taken at the local multidisciplinary meeting based on the radiological findings. Perioperative and oncological outcomes were assessed and compared between the EL and non-EL group prospectively...
March 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28108013/detection-of-extra-regional-tumour-recurrence-with-18-f-fdg-pet-ct-in-patients-with-recurrent-gynaecological-malignancies-being-considered-for-radical-salvage-surgery
#15
H Brar, T May, N Tau, D Langer, P MacCrostie, K Han, U Metser
AIM: To compare the detection rate of extra-regional metastases in patients with recurrent gynaecological malignancies being considered for radical salvage surgery with combined 2-[(18)F]-fluoro-2-deoxy-d-glucose ((18)F-FDG) positron-emission tomography (PET)/computed tomography (CT) compared to conventional imaging. MATERIALS AND METHODS: A retrospective review was performed of all patients in a provincial database with recurrent gynaecological malignancies being considered for pelvic exenteration that underwent restaging with CT/PET between March 2011 and October 2014...
April 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28106653/outcomes-of-rectovaginal-fistula-repair
#16
Jenifer N Byrnes, Jennifer J Schmitt, Benjamin M Faustich, Kristin C Mara, Amy L Weaver, Heidi K Chua, John A Occhino
OBJECTIVES: Rectovaginal fistulae (RVF) often represent surgical challenges, and treatment must be individualized. We describe outcomes after primary surgical repair stratified by fistula etiology and surgical approach. METHODS: This retrospective cohort study included women who underwent surgical management of RVF at a tertiary care center between July 1, 2001 and December 31, 2013. Cases were stratified according to the following etiology: cancer (RVF-C), inflammatory bowel disease or infectious (RVF-I), and other (RVF-O)...
March 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28095995/pelvic-floor-reconstruction-by-modified-rectus-abdominis-myoperitoneal-mram-flap-after-pelvic-exenterations
#17
D Cibula, M Zikan, D Fischerova, R Kocian, A Germanova, A Burgetova, L Dusek, Z Fartáková, M Schneiderová, K Nemejcová, J Slama
OBJECTIVE: To describe the technique and report experiences with pelvic floor reconstruction by modified rectus abdominis myoperitoneal (MRAM) flap after extensive pelvic procedures. METHODS: Surgical technique of MRAM harvest and transposition is carefully described. The patients in whom pelvic floor reconstruction with MRAM after either infralevator pelvic exenteration and/or extended lateral pelvic sidewall excision was carried out were enrolled into the study (MRAM group, n=16)...
March 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28078119/surgical-outcomes-of-post-chemoradiotherapy-unresectable-locally-advanced-rectal-cancers-improve-with-interim-chemotherapy-is-folfirinox-better-than-capox
#18
Vikas Ostwal, Reena Engineer, Anant Ramaswamy, Arvind Sahu, Saurabh Zanwar, Suprita Arya, Supriya Chopra, Munita Bal, Prachi Patil, Ashwin Desouza, Avanish Saklani
BACKGROUND: Role of chemotherapy in patients who continue to have unresectable disease after pre-operative chemo-radiotherapy (CRT) remains largely unaddressed. METHODS: Patients with LA rectal cancer from January 2013 to June 2015 were evaluated. Post-CRT, patients, who were deemed unresectable, were considered for further interim chemotherapy (i-CT). RESULTS: Seventy six patients (15%) with median age of 38.5 years received i-CT after CRT...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28070552/long-term-survival-after-anterior-pelvic-exenteration-and-total-vaginectomy-for-recurrent-endometrial-carcinoma-with-metastatic-inguinal-nodes-at-the-time-of-surgery
#19
Benjamin Margolis, Sun Woo Kim, Dennis S Chi
•Pelvic exenteration can be used in patients with multifocal recurrence.•Ability to achieve negative margins remains a necessity for pelvic exenteration.•Individualized treatments are essential for those with recurrent malignancy.
February 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28027809/-laparoscopic-anterior-pelvic-exenteration-in-a-patient-with-locally-advanced-melanoma
#20
David Isla-Ortiz, Gonzalo Montalvo-Esquivel, Roberto Eduardo Herrera-Goepfert, Ángel Herrera-Gómez, Rosa Angélica Salcedo-Hernández
BACKGROUND: Pelvic exenteration is one of the most mutilating surgical procedures with high post-operative morbidity. The laparoscopic technique aims to reduce perioperative complications and reduce post-surgical recovery. OBJECTIVE: We present the first case of laparoscopic anterior exenteration for locally advanced melanoma, held at the National Cancer Institute and published in Mexico. CASE REPORT: Patient 60 years of age diagnosed with invasive vulvar melanoma with bladder extension upon whom laparoscopic anterior pelvic exenteration with external urinary reconstruction was performed...
December 24, 2016: Cirugia y Cirujanos
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