Surgery and OncologySurgery and OncologyХирургия и онкология2949-5857Publishing House ABV Press2010.17650/2220-3478-2012-0-2-46-52ORIGINAL REPORTSОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯTotal pelvic exenterations in patients with locally advanced primary and recurrent rectal tumors: possibilities of urinary tract reconstructionТотальные экзентерации малого таза у пациентов с местно-распространенными первичными и рецидивными опухолями прямой кишки: возможности реконструкции мочевыделительной системыAlekseyevB. Ya.АлексеевБ. Я.
Russian Federation
SidorovD. V.СидоровД. В.
Russian Federation
GrishinN. A.ГришинН. А.
Russian Federation
LozhkinM. V.ЛожкинМ. В.
Russian Federation
TroyizkiyA. A.ТроицкийА. А.
Russian Federation
PetrovL. O.ПетровЛ. О.
Russian Federation
leonid_petrov@mail.ruShlyakovS. L.ШляковС. Л.
Russian Federation
FetisovaYe. Yu.ФетисоваЕ. Ю.
Russian Federation
P.A. Herzen Moscow Oncology Research Institute, Ministry of Health and Social Development of RussiaФГБУ Московский научно-исследовательский онкологический институт им. П.А. Герцена инздравсоцразвития России2702201212465225022015Copyright ©; 2012, ABV-pressCopyright ©; 2012, АБВ-пресс2012ABV-pressАБВ-прессhttps://onco-surgery.info/jour/about/editorialPolicieshttps://onco-surgery.info/jour/article/view/20

Surgical and long-term results of 14 total pelvic exenteration were analyzed. The group included 6 patients (5 men, 1 woman) with primary rectal cancer, and 8 patients (7 men, 1 woman) with the locally-advanced recurrent rectal cancer. The mean operative time was 403 ± 133.1 min (from 240 to 680 min). The average blood loss — 5169 ml (1200 to 15 000 ml). Both female patients were underwent infralevatoric total pelvic exenteration. Supralevatoric total pelvic exenteration were performed in 5 male patients. In these patients full recovery of the colon passage, and in the urinary tract — orthotopic plastic of the urinary bladder (Studer procedure) was achieved. R0 resection was performed in 11 (78.5 %) cases, the presence of microscopic tumor growth in the lateral resection margin was found in 3 (21.5 %)  patients (R1). Postoperative complications occurred in 8 patients, requiring surgical correction in 3 cases. Long-term results were followed up in 12 patients during the period from 16 to 57 months after surgery (median — 31 months). Overall survival in these periods was  83.3 % (10 patients). Disease-free survival — 75 % (9 patients). Influence of the reconstruction phase on the long-term results was not observed. Functional results are evaluated as good in all patients after orthotopic plastic of the bladder. Performing of pelvic exenteration for patients with locally advanced rectal cancer is a chance to achieve radical removal of the tumor and, as a consequence, the long-term survival in this extremely difficult group of patients. Performing of full reconstruction of the urinary tract allows to improve the quality of life of patientswith no adverse influence on oncologic outcomes.

 

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