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Exenteration pelvic surgery

Marilla Dickfos, Stephanie B M Tan, Andrew R L Stevenson, Craig A Harris, Rachel Esler, Matthew Peters, David G Taylor
BACKGROUND: Over one-third of primary rectal cancers are locally advanced at diagnosis, and local recurrence of rectal cancer occurs at a rate of 3-10% following primary curative resection. Extended resectional surgery, including pelvic exenteration, is the only proven therapy with curative potential in the treatment of these cancers along with many other pelvic malignancies. A microscopically clear resection margin (R0 resection) is the predominant prognostic factor affecting overall and disease-free survival...
March 6, 2018: ANZ Journal of Surgery
Daniel Steffens, Jane Young, Paula R Beckenkamp, James Ratcliffe, Freya Rubie, Nabila Ansari, Neil Pillinger, Michael Solomon
BACKGROUND: There is a need for evidence of the effectiveness of pre-operative exercise for patients undergoing major cancer surgery; however, recruitment to such trials can be challenging. The PrE-operative Physical Activity (PEPA) Trial will establish the feasibility and acceptability of a pre-operative exercise programme aimed to improve patient outcomes after cytoreductive surgery and pelvic exenteration. The secondary aim is to obtain pilot data on the likely difference in key outcomes (post-operative complications, length of hospital stay, post-operative functional capacity and quality of life) to inform the sample size calculation for the substantive randomised clinical trial...
February 17, 2018: Trials
Sandra L Kopp, William L Lanier
No abstract text is available yet for this article.
March 2018: Diseases of the Colon and Rectum
Roberto Berretta, Vito Andrea Capozzi, Giulio Sozzi, Lavinia Volpi, Valentina Ceni, Mauro Melpignano, Giovanna Giordano, Federico Marchesi, Michela Monica, Maurizio Di Serio, Matteo Riccò, Marcello Ceccaroni
PURPOSE: The aim of this retrospective study is to analyze the prognostic role and the practical implication of mesenteric lymph nodes (MLN) involvements in advanced ovarian cancer (AOC). METHODS: A total of 429 patients with AOC underwent surgery between December 2007 and May 2017. We included in the study 83 patients who had primary (PDS) or interval debulking surgery (IDS) for AOC with bowel resection. Numbers, characteristics and surgical implication of MLN involvement were considered...
January 27, 2018: Archives of Gynecology and Obstetrics
Pedro Marcos-Figueiredo, Diana de Sousa da Costa Moreira, Manuel Gonçalves Morim, Júlia Leite Pereira, Lurdes Silva Salgado
Vaginal cancer is a rare entity. The evidence on its management resides mostly in clinical cases or small case series. Of the histological types, the most frequent is the squamous cell carcinoma, followed by adenocarcinoma. But what to do when identifying an even more infrequent sarcoma in a premenopausal woman? In this study, we describe the case of a 53-year-old woman presenting with metrorrhagia for two months, who was evaluated after an intense episode. A necrotic and ulcerative vaginal swelling was documented and then submitted to biopsy, which revealed a vaginal sarcoma...
January 2018: Revista Brasileira de Ginecologia e Obstetrícia
Glen R Guerra, Joseph C Kong, Maria-Pia Bernardi, Robert G Ramsay, Wayne A Phillips, Satish K Warrier, A Craig Lynch, Samuel Y Ngan, Alexander G Heriot
BACKGROUND: Anal squamous cell carcinoma is a rare cancer with a high cure rate, making research into the treatment of locoregional failure difficult. OBJECTIVE: The purpose of this study was to examine factors related to local treatment failure and determine the outcomes of patients undergoing local salvage resection. DESIGN: This was a retrospective cohort study. SETTING: This study was conducted at a quaternary referral center...
February 2018: Diseases of the Colon and Rectum
Se Ik Kim, Seungmee Lee, Chang Wook Jeong, Hee Seung Kim
OBJECTIVE: Melanomas of the vulva and vagina are rare, and surgery is the gold standard of treatment [1, 2]. Since recent studies have reported pelvic exenteration by using robotic surgical system [3, 4], we showed the surgical procedures of robot-assisted anterior pelvic exenteration (rAPE) with ileal conduit urinary diversion for vulvovaginal malignant melanoma. METHODS: A 55-year-old woman who received vaginal wall resection due to vaginal malignant melanoma 8months before was referred...
February 2018: Gynecologic Oncology
Kazuyoshi Kato, Kohei Omatsu, Maki Matoda, Hidetaka Nomura, Sanshiro Okamoto, Hiroyuki Kanao, Kuniko Utsugi, Nobuhiro Takeshima
OBJECTIVE: The aim of this study was to investigate the clinical usefulness of the placement of a transanal drainage tube (TDT) to prevent anastomotic leakage after a modified posterior pelvic exenteration (MPPE) for the treatment of primary ovarian cancer. METHODS: We performed a retrospective review of all the consecutive patients who had undergone an MPPE for primary ovarian, tubal, or peritoneal cancer between October 2012 and November 2016 at our institution...
February 2018: International Journal of Gynecological Cancer
E Schloericke, M Zimmermann, C Benecke, T Laubert, R Meyer, H-P Bruch, R Bouchard, T Keck, M Hoffmann
BACKGROUND: Patients with rectovaginal fistulas have a significantly reduced quality of life. Therefore, surgical therapy is often needed even in palliative cases. The aim of the present study was to perform an analysis of the results of the different treatment options available today. METHODS: We performed a retrospective analysis of patients who underwent treatment for rectovaginal fistulas at the Department of Surgery, University of Schleswig-Holstein, Campus Luebeck and the Department of Surgery, WKK Heide, between January 2000 and September 2016...
December 2017: Techniques in Coloproctology
A Martinez, T Filleron, P Rouanet, P Méeus, E Lambaudie, J M Classe, F Foucher, F Narducci, S Gouy, F Guyon, F Marchal, E Jouve, P E Colombo, A Mourregot, M Rivoire, N Chopin, G Houvenaeghel, I Jaffre, J Leveque, V Lavoue, E Leblanc, P Morice, E Stoeckle, J L Verheaghe, D Querleu, G Ferron
BACKGROUND: Pelvic exenteration remains one of the most mutilating procedures, with important postoperative morbidity, an altered body image, and long-term physical and psychosocial concerns. This study aimed to assess quality of life (QOL) during the first year after pelvic exenteration for gynecologic malignancy performed with curative intent. METHODS: A French multicentric prospective study was performed by including patients who underwent pelvic exenteration...
November 20, 2017: Annals of Surgical Oncology
Jumpei Oshima, Tatsuya Kinoshita, Norihide Tei, Yasunori Harada, Seiji Oka, Kensaku Nishimura, Kiyoshi Mori
We report a case of inflammatory pseudotumor of the ureter. An 81-year-old man who had an operation of pelvic exenteration with ileal conduit presented with right flank pain. Computed tomography revealed a 16 mm mass of the right ureter with right hydronephrosis and renal atrophy. The mass increased in size during follow up. Right nephroureterectomy was performed with suspicion of ureteral cancer. Histopathological finding showed an inflammatory pseudotumor. No obvious recurrence has been observed for 33 months after the surgery...
October 2017: Hinyokika Kiyo. Acta Urologica Japonica
Ying Guo, Eugene Chang, Mehtap Bozkurt, Minjeong Park, Diane Liu, Jack B Fu
BACKGROUND AND OBJECTIVES: Total pelvic exenteration are performed in patients with locally advanced or recurrent pelvic malignances. Many patients have prolong hospital length of stay (LOS), but risk factors are not clearly identified. METHODS: From 2002 through 2012, 100 consecutive patients undergoing pelvic exenteration were retrospectively reviewed. A general linear model was used to examine risk factors for prolonged hospital LOS. RESULTS: Among the 100 patients, 51 had gastrointestinal cancer, 14 had genitourinary cancer, 31 had gynecologic cancer, and 4 had sarcoma...
October 16, 2017: Journal of Surgical Oncology
Jonas Amstrup Funder, Rikke Tolstrup, Betina Norman Jepsen, Lene Hjerrild Iversen
BACKGROUND: Paralytic postoperative ileus (POI) is associated with increased morbidity and mortality after abdominal surgery. Despite increased awareness and implementation of various measures, POI remains a problem, perhaps moreso for those patients undergoing extensive oncological surgical treatment. The aim of this study was to describe the extent of POI after advanced cancer surgery in the era of contemporary treatment modalities of POI. METHODS: A retrospective analysis of all patients who underwent either abdominoperineal excision with transpelvic vertical rectus abdominal musculocutaneous (VRAM)-flap after anal cancer or pelvic exenteration at single institution from January 2012 to November 2013 was carried out...
October 2017: Journal of Surgical Research
Se Young Choi, Sangjun Yoo, Jae Hyeon Han, In Gab Jeong, Bumsik Hong, Jun Hyuk Hong, Hanjong Ahn, Choung-Soo Kim, Dalsan You
OBJECTIVES: To evaluate predictors of organ involvement and oncological outcomes after radical cystectomy with anterior exenteration in female patients. METHODS: Among 1198 patients who underwent radical cystectomy for the bladder tumor between 1990 and 2015, 178 (14.9%) patients were female. They were divided into two groups according to pelvic involvement in pathology. Their medical records and pathology and image findings were reviewed retrospectively. Non-urothelial cell carcinoma and no genital organ pathology were excluded...
November 2017: International Journal of Surgery
J Šimša, V Visokai, L Lipská, M Levý, R Zachoval
INTRODUCTION: Pelvic exenteration is an essential part of complex treatment of advanced tumours of the small pelvis. The strategy of surgery is well known and consensual. However, the optimal extent of lymphadenectomy is still under discussion. The aim of this paper is to summarize the strategy of surgery and the extent of lymphadenectomy. METHODS: Review of the literature and retrospective analysis of 63 patients of our cohort, operated on at the Department of Surgery of the First Faculty of Medicine, Charles University and Thomayer Hospital between 1999-2015...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Muhammad Amir Saeed Khan, Chin W Ang, Abdul Rahman Hakeem, Nigel Scott, Rick Nigel Saunders, Ian Botterill
AIM: The clinico-oncological significance of the distance of rectal cancer from the anal verge is unclear and not well reported. The aim of this study is to assess the influence of the rectal cancer distance from the anal verge on clinical management and long-term outcomes after curative resection in a specialised colorectal cancer unit. METHODS: Prospectively collected data on patients who underwent primary rectal cancer treatment at our unit between January 2005 and December 2010 were analysed...
December 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
B Smith, E L Jones, M Kitano, A L Gleisner, N J Lyell, G Cheng, M D McCarter, S Abdel-Misih, F J Backes
OBJECTIVE: Pelvic exenteration (PE) is often the only curative option for locally advanced or recurrent pelvic malignancies. Despite radical surgery, recurrence risk and morbidity remain high. In this study, we sought to determine tumor size effect on perioperative outcomes and subsequent survival in patients undergoing PE. METHODS: Retrospective chart review was performed for female patients who underwent PE at two comprehensive cancer centers from 2000 to 2015...
November 2017: Gynecologic Oncology
Antonio Macrì
Pelvic exenteration is a radical surgery that can require urinary and faecal diversions. Double-barreled wet colostomy, a viable alternative to the traditional ileal conduit with separate colostomy technique, is not always applicable due to the shortness of an ureter. To overcome this problem, I modified the original technique, replacing the two uretero-colic anastomoses with an ureteroureterostomy and an uretero-colic anastomosis.
December 2017: Updates in Surgery
Cihan Ağalar, Aras Emre Canda, Tarkan Unek, Selman Sokmen
Locally advanced right colon cancer may invade adjacent tissue and organs. Direct invasion of the duodenum and pancreas necessitates an en bloc resection. Previously, this challenging procedure was associated with high morbidity and mortality; however, today, this procedure can be done more safely in experienced centers. The aim of this study is to report our experience on en bloc right colectomy with pancreaticoduodenectomy for locally advanced right colon cancers. Between 2000 and 2012, 5 patients underwent en bloc multivisceral resection...
2017: International Journal of Surgical Oncology
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
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