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Pelvic exenteration

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https://www.readbyqxmd.com/read/28808931/robotic-total-pelvic-exenteration-video-illustrated-technique
#1
Ioannis T Konstantinidis, William Chu, Federico Tozzi, Clayton Lau, Mark Wakabayashi, Kevin Chan, Byrne Lee
BACKGROUND: Robotic-assisted total pelvic exenteration (TPE) can offer a minimally invasive approach to a major multi-organ operation. METHODS: In this video, we summarize a stepwise approach to robotic TPE in a 70 year-old female Jehovah's witness with a history of cervical cancer post-chemoradiation and radical hysterectomy who experienced local recurrence at the vaginal cuff involving the rectum and bladder. RESULTS: The patient was placed in the lithotomy position...
August 14, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28808913/modified-double-barrelled-wet-colostomy-after-total-pelvic-exenteration
#2
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.
August 14, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28751989/en-bloc-pancreaticoduodenectomy-for-locally-advanced-right-colon-cancers
#3
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
https://www.readbyqxmd.com/read/28747229/vaginal-metastasis-as-the-initial-presentation-of-leiomyosarcoma-a-case-report
#4
Cecilia Villalaín-González, Álvaro Tejerizo-García, Patricia Lopez-Garcia, Gregorio López-González, Ma Reyes Oliver-Perez, Jesús S Jiménez-López
BACKGROUND: Uterine leiomyosarcomas are very rare and highly aggressive tumors that have a high rate of recurrence and poor prognosis, even when early diagnosed. Due to their relative rarity, there is limited research on optimal management strategies. CASE PRESENTATION: A 60-year-old woman with a history of an asymptomatic uterine leiomyoma presented in October 2015 with postmenopausal bleeding and a friable vaginal cyst that bled when palpated. A partial cystectomy was performed, and malignant-like cystic and solid components were identified...
July 26, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28721294/a-prospective-evaluation-of-surgical-outcomes-of-laparoscopic-transperitoneal-radical-cystectomy-anterior-pelvic-exenteration-our-surgical-technique-and-experience
#5
Anup Kumar, Niraj Kumar, Gaurav Kumar, Mikir Patel, Pankaj Gupta
No abstract text is available yet for this article.
June 30, 2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/28638794/biological-mesh-reconstruction-of-the-pelvic-floor-following-abdominoperineal-excision-for-cancer-a-review
#6
REVIEW
Boris Schiltz, Nicolas Christian Buchs, Marta Penna, Cosimo Riccardo Scarpa, Emilie Liot, Philippe Morel, Frederic Ris
Extralevator abdominoperineal excision and pelvic exenteration are mutilating operations that leave wide perineal wounds. Such large wounds are prone to infection and perineal herniation, and their closure is a major concern to most surgeons. Different approaches to the perineal repair exist, varying from primary or mesh closure to myocutaneous flaps. Each technique has its own associated advantages and potential complications and the ideal approach is still debated. In the present study, we reviewed the current literature and our own local data regarding the use of biological mesh for perineal wound closure...
June 10, 2017: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28616793/pelvic-exenteration-with-en-bloc-resection-of-the-pelvic-sidewall-and-intraoperative-electron-beam-radiotherapy-with-mobetron-%C3%A2-for-locally-advanced-rectal-cancer
#7
K Rangarajan, R Bhome, N Bateman, A Naga, M Simon, K Donovan, J Smith, A H Mirnezami
No abstract text is available yet for this article.
June 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28594725/pelvic-exenteration-surgery-the-evolution-of-radical-surgical-techniques-for-advanced-and-recurrent-pelvic-malignancy
#8
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
#9
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 women who underwent radical surgery in the form of modified posterior pelvic exenteration. Descriptive statistics, Kaplan-Meier survival curves and log-rank test were used for statistical estimations...
September 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
#10
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...
August 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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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/28481859/transanal-total-pelvic-exenteration-pushing-the-limits-of-transanal-total-mesorectal-excision-with-transanal-pelvic-exenteration
#19
Dai Uematsu, Gaku Akiyama, Takehiko Sugihara, Akiko Magishi, Takuya Yamaguchi, Takayuki Sano
No abstract text is available yet for this article.
June 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28481857/the-evolution-of-pelvic-exenteration-practice-at-a-single-center-lessons-learned-from-over-500-cases
#20
Cherry E Koh, Michael J Solomon, Kilian G Brown, Kirk Austin, Christopher M Byrne, Peter Lee, Jane M Young
Considerable progress has been made in the management of patients with locally advanced or recurrent cancers of the pelvis over the past 60 years since the inception of pelvic exenteration. Early progress in pelvic exenteration was marred by the high surgical mortality and morbidity, which drew scepticism from the broader surgical community. Subsequent evolution in the procedure hinged on establishing surgical safety and a better understanding of outcome predictors. Surgical mortality from pelvic exenteration is now comparable to that of elective resection for primary colorectal cancers...
June 2017: Diseases of the Colon and Rectum
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