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At least 577 records · Page 32Linked to original sources
PubMed1985

Vicryl mesh in pelvic floor reconstruction.

A new synthetic absorbable mesh made of polyglactin 910 (Vicryl) fiber was used to reconstruct the pelvic floor in seven women undergoing pelvic exenteration. The technique is described. The follow-up ranged from three to 31 months and no patient developed a bowel problem. The material seems to be appropriate for this use, is completely absorbed, and acts as a latticework for the deposition of granulation tissue. The technique can be applied in patients requiring pelvic irradiation following surgery for malignant neoplasms of the gastrointestinal or genitourinary tracts. The small bowel is effectively held out of the pelvis and the radiation field, and is spared the effects of the radiation beam.

Adult↗
PubMed1991

[Repair surgery in the treatment of cancer of the cervical remnant].

The protocol recommended at the Centre Alexis Vautrin for the treatment of cancer of the cervical remnant is purely radiographic. The authors investigates repair surgery after the failure of radiotherapy in 8 cases, representing 9.3% of cases. He defines cancer of the cervical remnant by stressing the importance of a particularly difficult assessment of the extension and the methods of treatment. The series included 5 cases of cervicocolpectomies and 3 pelvic exenterations. The context was particularly unfavorable since the tumor had been irradiated and had developed a scarred region. Serious complications were not present in this series, but they should be recognized so that they can be prevented and some procedures adapted to local conditions, which include bladder, rectal and ureteral fistulae, occlusion and pelvic abscess. The rationale for surgery is based on the possibility of a cure and the prevention of locoregional progress which may be particularly painful and handicapping.

Adenocarcinoma↗
PubMed1989

["Inoperable" deep rectal cancer].

Rectal carcinoma usually requires surgery. In 1981-1988 43 (8.5%) of 504 patients were considered inoperable for medical, prognostic or technical reasons. Surgery should take the removal of urogenital organs, if necessary, into consideration. Electrosurgery, cryosurgery and laser surgery can be used to reestablish local passage. Twenty-one pelvic exenterations were performed during 52 operations for tumor recurrence. Adjuvant chemotherapy and radiotherapy were applied when needed. Each therapy must be individualized.

Combined Modality Therapy↗
PubMed2001

[Rectal carcinoma--oncologically adequate resection].

The local recurrence rate is besides distant metastatic spread the most relevant factor for the longterm survival of patients with rectal cancer. Of decisive importance are the experienced surgeon and special techniques such as the precise mesorectal dissection with respect of the holy planes. Total mesorectal excision (TME) for carcinomas of the lower and middle third of the rectum and a sufficient distal margin of 2 cm reduced the local recurrence rate to below 10% and allow sphincter preservation in more than 80%. The local excision is ideal for low-risk-patients with circumscript T1-tumors. In high-risk-patients the operation should be followed by additional chemoradiation therapy. Multivisceral surgery and pelvic exenteration do have a place in patients with locally advanced tumors, which should be treated by neoadjuvant radiochemotherapy. Laparoscopic operations of rectal cancer show first promising results but should, however, be restricted to controlled clinical trials.

Chemotherapy, Adjuvant↗
PubMed1993

[Composite resection of sciatic nerve for local recurrence of rectal cancer].

Three patients with local recurrence of rectal cancer involving the sciatic nerve underwent radical pelvic exenteration combined with sciatic nerve resection. This surgical procedure resulted in complete relief of intolerable cancer pain in all patients. After the rehabilitation, all could walk unassisted by wearing only a below-the-knee leg brace. The first patient died 16 months postoperatively due to multiple liver metastasis, but no local recurrence was documented. The second patient is alive 13 months postoperatively with bone and liver metastasis and pelvic wall recurrence. The third patient is alive 7 months postoperatively with no evidence of disease. Composite resection of lateral sciatic nerve improved the quality of life in patients who had local recurrence of rectal cancer with sciatic nerve involvement.

Adult↗
PubMed1977

Acquired vulvar lymphangiectasis in a child.

A unique case of extensive acquired vulvar lymphangiectasis without lymphedema in a child is described. This lesion developed after pelvic exenteration, lymphadenectomy, and radiation therapy for rhabdomyosarcoma of the bladder. These acquired etiologic factors simulated the pathophysiology of congenital lymphangioma. She was successfully treated with surgical excision and vulvar reconstruction.

Child↗
PubMed1976

Scalene node biopsy in the pretreatment staging of carcinoma of the cervix uteri.

This study reports the experience at the Ellis Fischel State Cancer Hospital with the use of scalene node biopsy for the pretreatment evaluation of patients with carcinoma of the cervix uter. The study was stimulated by a report from the National Cancer Institutes which stated that impalpable scalene nodes contained metastatic cancer in 13 per cent of a series of 84 cases. By a meticulous biopsy technique, we were unable to confirm this high incidence, In a series of 73 cases, no impalpable lymph nodes were found to contain metastatic cancer regardless of the clinical stage of the cancer. Consequently, we have terminated the use of scalene lymph node biopsies in the staging of cervical cancer for primary treatment. The study is still in progress to evaluate patients with recurrent cervical cancer who may possibly require pelvic exenteration. Also, the procedure will be continued in patients referred for further treatment in whom carcinoma was first diagnosed as an unsuspected finding in a hysterectomy specimen.

Adenocarcinoma↗
PubMed1987

Surgical approaches for advanced or recurrent cancer of the cervix.

The American Cancer Society estimates that in 1987 13,000 women in the United States will develop invasive cervical cancer, and 6800 women will die of this disease. Two groups of patients contribute significantly to mortality from cervical cancer. In the first group are patients who have an advanced stage of cervical cancer at the time of diagnosis. The second group consists of patients who have received unsuccessful primary treatment. Over the past decade the role of surgery in the management of patients with advanced disease has been studied with a view toward a more precise extent of disease evaluation prior to definitive therapy. The potential benefit of pretreatment surgical staging of cervical cancer is considered in this article. The role of pelvic exenteration in the treatment of recurrent cervical cancer has been established for more than 30 years. In this article recent advances in the application of these procedures including better criteria for patient selection, improvement in surgical techniques, and patient rehabilitation are discussed.

Female↗
PubMed1987

Treatment of urinary conduit fistula by antegrade ureteral stent catheter.

Two women with urinary conduit fistulas are presented. Both patients developed a conduit fistula postoperatively after total pelvic exenteration. The fistulas were managed successfully by inserting an antegrade ureteral stent catheter via a percutaneous nephrostomy. The details of the method used to perform this procedure are described in detail, and risks and benefits are reviewed.

Female↗
PubMed1977

Vulvovaginoplasty in gynecologic oncology.

Eight patients from M.D. Anderson Hospital underwent Williams' vulvovaginoplasty for sexual rehabilitation following pelvic exenteration. In 7 of the 8 patients the functional results were excellent, and none of the patients experienced morbidity. This surgical procedure is less extensive than other reconstructive methods and skin grafting or mechanical dilatation are rarely required.

Adult↗
PubMed1975

Ureteroarterial fistula.

Among the many complications of total pelvic exenteration is a fistulous communication between the iliac artery and ureter. We reported 1 such case complicated by near exsanguination and shock. Repair of the fistula was accomplished by closure of the iliac rent and cutaneous ureterostomy.

Female↗
PubMed1997

[Leiomyosarcoma of the vagina: a rare case].

Vaginal leiomyosarcoma is unfrequent. We report on a case in a 50-year-old multipara patient who had presented a posterior vaginal swelling since 6 months. The tumor was discovered at the occasion of pains and non hemorragic discharge. The histological pattern of the tumor was well-differentiated spindle cell sarcoma with pleiomorphic areas. The immunohistochemistry confirmed the smooth myogenic differentiation. The treatment consisted of posterior pelvic exenteration extended to the vagina. The patient is alive and free of disease at 20 months of fellow-up.

Female↗
PubMed1985

[Gracilis muscle flaps for covering losses of perineal substance in cancer surgery].

Myocutaneous or purely muscular flaps were used in 14 patients after extended surgical excision in the perineal region. When taking out the flap, its one-pedicle and relatively weak blood supply must be taken into account. With this precaution, this technics can always be used for perineal resurfacing, particularly after total vulvectomy. In pelvic exenteration and amputation for anorectal cancer, it enables surgeons to fill the muscular gap, which seems to improve the post-operative course. It can also be used for vaginal, penile or sphincteric reconstruction.

Anus Neoplasms↗
PubMed1975

Sigmoid conduit urinary diversion.

The courses of 11 patients with sigmoid conduit urinary diversion following total pelvic exenteration were reviewed in detail and the results presented. The sigmoid conduit appears to be a safe alternative to the ileal conduit for urinary diversion, and offers in addition the possible advantage of an effective antirefluxing ureterocolic anastomosis.

Adult↗
PubMed2001

Surgical management of advanced or recurrent endometrial cancer.

Most patients who have endometrial cancer are diagnosed with early stage disease and have excellent long-term survival. For patients who have evidence of metastatic disease at surgery, there is a survival benefit to be gained if all gross evidence of disease can be resected. Even in cases in which complete gross excision cannot be attained, surgical debulking to small-volume residual disease leads to an improved prognosis compared with patients left with bulky residual disease. Patients with endometrial cancer who have not previously received pelvic irradiation and develop isolated pelvic recurrences can be effectively treated with pelvic radiotherapy. The treatment options for patients who develop recurrent disease are limited. Hormonal and chemotherapeutic treatments typically do not provide durable responses. In carefully selected patients with isolated central recurrences, pelvic exenteration is the only potential option for cure. Long-term survival has been achieved although complication rates are significant. Further investigation into the techniques of IORT may increase the pool of patients for whom surgically based salvage therapy may be offered.

Disease-Free Survival↗
PubMed1978

Plastic procedures in cancer of the lower genital tract.

Plastic procedures were performed on 12 patients with cancer in situ of the vulva or vagina or after pelvic exenteration. All patients are alive and well on follow-up from four to 47 months with no evidence of recurrence. Plastic procedures are very important in treatment of cancer of the lower genital tract. The split-thickness graft used in this study is optimal in terms of treatment appearance, and restoration of sexual function.

Adult↗
PubMed1993

[A case of clear cell adenocarcinoma of the female urethra].

A 49-year-old female visited our hospital because of bloody discharge from the urethra. On examination, an elastic-soft mass was palpable beneath the anterior vaginal wall. The vaginal mucosa was intact. Cystourethroscopy demonstrated neither tumor nor diverticular orifice. Pathological specimen obtained by needle biopsy revealed clear cell adenocarcinoma. The patient underwent anterior pelvic exenteration and modified Kock pouch urinary diversion. The microscopic appearance suggested that the tumor arose from the paraurethral duct. Stains for prostatic specific antigen and prostate specific acid phosphatase were negative. Forty cases of clear cell adenocarcinoma of the female urethra reported in the literature were reviewed.

Adenocarcinoma, Clear Cell↗
PubMed1992

[Signet-ring cell adenocarcinoma involving the bladder and the rectum. Apropos of two cases].

Two cases of primary signet-ring cell carcinoma involving the urinary bladder, with invasion of the rectum, are presented. Pelvic exenterations were performed, followed by a rapidly fatal outcome (6 and 7.5 months). These cases of signet-ring cell carcinoma of the bladder were reviewed with 33 previously reported cases in the literature. The clinical characteristics, histologic findings, pathogenesis, and effectiveness of aggressive treatment of this rare bladder malignancy are discussed.

Humans↗