Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PELVIC EXENTERATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 595 records · Page 33Linked to original sources
PubMed2003

Innovations in the treatment of invasive cervical cancer.

Invasive cervical cancer is characterized by basement membrane-invading lesions capable of metastasizing through the lymphatic and vascular systems. Treatment methods were reviewed by panelists at the Second International Conference on Cervical Cancer (Houston, TX, April 11-14, 2002), and new opportunities for translational research were discussed. Reviews encompassed hysterectomy with or without lymph node dissection or cervical conization in cases with microinvasion and radical trachelectomy with or without lymph node dissection as fertility-sparing surgery. Chemoradiation is used to treat advanced cervical malignancies, and the risks and benefits of radiotherapy are significant. Pelvic exenteration is used to treat certain types of recurrences. Use of the Miami pouch for continent urinary diversion was highlighted. Gynecologic oncologists expect novel in vivo imaging techniques currently being developed to help guide therapy choices within the next decade. The most significant research priorities are large group-randomized trials involving fertility-sparing procedures and the management of microinvasive carcinoma (MICA); better identification of candidates for chemoradiation; and the development of innovative approaches to exenteration. Improving diagnostic technologies, refining the criteria by which therapies are chosen, and preserving fertility remain challenges in selecting the most appropriate treatment for invasive cervical cancer. Research advances in both diagnosis and treatment are expected to improve therapy and outcomes.

Combined Modality Therapy↗
PubMed1986

Changing trends in the surgical treatment of invasive carcinoma of the vulva.

Twenty-nine years experience with 346 patients with invasive carcinoma of the vulva is presented. More than 90 per cent had squamous carcinoma. The primary mode of treatment was surgical. Two hundred and ninety-six patients were treated primarily with surgical treatment, 120 underwent radical vulvectomy and bilateral groin and pelvic lymphadenectomy, 133 had radical vulvectomy with bilateral groin dissection and 390 receiving nonradical procedures. Thirteen patients had radical operations plus pelvic exenteration for advanced disease. There were no intraoperative deaths, but 16 (5.4 per cent) died within 28 days of the operation. The uncorrected over-all five year survival rate was 66 per cent. In the presence of negative nodes, it was 83 per cent and with positive nodes, it was 38 per cent. Fifty per cent of those treated with exenteration are alive and disease-free at five years or more. Since one-third of the patients presented with advanced disease (Stages III and IV), earlier diagnosis and prompt referral must be encouraged to improve surgical results.

Adult↗
PubMed1994

[A case of transitional cell carcinoma of the prostate].

A 46-year-old man was admitted to our hospital with the complaint of gross hematuria and renal failure. The patient had undergone right nephrectomy 10 years earlier suffering from nephrotuberculosis, and the remaining left side manifested severe hydronephrosis and vesicoureteral reflux (VUR). After the immediate nephrostomy, renal function was recovered and hematuria was improved preservatively. By the rectal examination, a goose egg size and stony hard prostate was detected. The needle biopsy of the prostate revealed pathologically transitional cell carcinoma (TCC) G2, and the image findings showed stage of T4N0M0 of the prostatic carcinoma. Modified pelvic exenteration was performed, and specimens were examined by the step section method. The diagnosis was TCC, G2 > G3 and stage of pT4N0 in the right lobe of the prostate. This case is she 20th reported case in Japan. We emphasize the importance of the mapping of dissected specimens and the reviewed literature.

Carcinoma, Transitional Cell↗
PubMed1989

A new technique of vaginal reconstruction using neurovascular pudendal-thigh flaps: a preliminary report.

The blood supply to the skin of the perineum, medial groin, and upper thigh was studied in fresh female cadavers. The pudendal-thigh flap was designed as a result to reconstruct the vagina. The flaps are raised bilaterally in the groin crease just lateral to the labia majora and then are transposed toward the midline and sutured together to form a skin-lined cul-de-sac which opens at the introitus. The technique has been used successfully in three patients to reconstruct the vagina. The first patient, an adult, was reconstructed after total pelvic exenteration for malignancy, while two children had reconstructions for congenital vaginal anomalies. This technique is superior to currently available methods because it is simple and reliable. No stents or dilators are needed. It is safe technique without complications in our hands. The reconstructed vagina has a natural angle for intercourse and is sensate. The donor scars in the groin are well hidden.

Adult↗
PubMed1988

Reconstructive techniques in gynecologic oncology: the use of human dura mater allografts.

Human dura mater has been utilized in various reconstructive procedures following radical pelvic surgery at the Division of Gynecologic Oncology, University of Miami School of Medicine. Our preliminary results indicate that this allograft is strong, durable, and acts as a good biological barrier. However, it does not seem to prevent the development of enteropelvic fistulae in patients who undergo total pelvic exenteration following radiotherapy. Dura mater has also been employed in abdominal hernia repairs, repair of wound dehiscenses, and in the coverage of the femoral vessels after groin dissection. Provisional results with these reconstructive techniques appear promising. These results are discussed, and suggestions regarding the use of this allograft are delineated.

Carcinoma, Squamous Cell↗
PubMed1984

Ureteroarterial fistula: a case report.

We report on a patient with a fistula between the right common iliac artery and the distal right ureter who had undergone pelvic exenteration for carcinoma of the uterine cervix. The patient also had received prior radiation therapy and was being treated with an indwelling ureteral stent at the time the fistula developed. Diagnosis was made by an occlusive ureterogram and the lesion was treated successfully with embolization of the common iliac artery.

Combined Modality Therapy↗
PubMed1998

Primary surgical cure of stage III-B cervical carcinoma with adnexal metastasis.

Management of patients with advanced stage cervical carcinoma remains suboptimal. Primary radiation therapy has been the standard treatment for years. Despite some changes in radiation technique, cure rates for advanced stage cervical cancer remain disappointing. Radiation complications in those patients can also be severe. We report here a case of a patient who presented with renal failure from bilateral ureteral obstruction from stage III-B cervical squamous carcinoma. The patient underwent a primary total pelvic exenteration with low rectosigmoid reanastomosis, urinary conduit construction, and cecal neovagina construction as definitive treatment. She was found to have metastasis to the broad ligament, ovary, and fallopian tube. Surgical margins and lymph nodes were negative. The patient did not receive any radiation therapy or chemotherapy. The patient is alive, healthy, and without evidence of disease 8 years following treatment.

Adnexal Diseases↗
PubMed1997

[A case of invasive bladder cancer with Pagetoid skin lesion of the vulva and anogenital Paget's disease].

A 70-year-old female was admitted to our hospital with a complaint of gross hematuria for two months. She had a 5 years history of eczematous vulvar skin eruption. With the diagnosis of T3N0M0 bladder cancer and anogenital Paget's disease, she underwent pelvic exenteration, vulvectomy and reconstruction of the vulva. Histopathological examinations and mucin stains revealed anogenital Paget's disease and invasive bladder cancer which extended to the clitoral skin and formed Pagetoid skin lesion. CEA and cyokeratin staining demonstrated identical expression pattern in bladder cancer cells and Paget's cells, which suggested both neoplastic cells originated from one progenitor cell.

Aged↗
PubMed2001

A practical approach to bladder sampling and diagnostic reporting of pathological findings.

The most common bladder specimens are obtained from endoscopic biopsies and transurethral resections (TURB), both of which sample subepithelial tissue of varying depth. Other specimens can be obtained from cystectomy, cystoprostatectomy, pelvic exenteration ("en bloc" resection), and partial cystectomy including resection of diverticulae and surgical excision of a urachal carcinoma. The correct assessment of bladder specimens may provide clinically relevant diagnostic and prognostic data. This protocol is intended to assist pathologists in providing clinically useful information as a result of examination of surgical specimens.

Biopsy↗
PubMed1992

[Pelvic multivisceral resection from the viewpoint of gynecology].

The pelvic exenteration procedure must be considered a multimodal therapeutic concept from a humanistic-medical point of view. Careful patient selection, radical resection of all tumor-infiltrated organs, complete interdisciplinary organ reconstruction, and optimal perioperative management including full psychosomatic rehabilitation are mandatory. This concept should only be realized in medical centers with highly sophisticated infrastructures.

Female↗
PubMed2003

Prostatic carcinosarcoma: a case report and review of literature.

A unique case of carcinosarcoma of the prostate detected in a 71-year-old man is presented. Pelvic exenteration was performed, and the resected prostatic mass was found to consist of two histologically distinct elements; adenocarcinoma and sarcoma with focal osteosarcomatous element. The patient is still alive with neither metastasis nor recurrence. This is the 42nd case of carcinosarcoma of the prostate to be reported in the literature.

Aged↗
PubMed2002

Current vulvar cancer treatment in Bulgaria.

PURPOSE OF INVESTIGATION: Our aim was to outline the treatment of carcinoma of the vulva at the National Oncological Centre in Sofia, Bulgaria. METHODS: We examined the records of 250 patients over a 10-year period treated at the Gynaecologic-Oncology Clinic of our Centre. RESULTS: There were 130 patients (52%) treated with surgery and radiation. There were 120 patients (48%) treated by surgery only. Thirty of these patients were treated by pelvic exenteration with radical vulvectomy. The five-year survival rate was 36% - 12 patients. The 1-year survival rate for all patients was 80% - 200 patients. The five-year survival rate was 50%. DISCUSSION: We have results similar to other clinics in the world working in this field. We now emphasize external radiation for advanced disease but the treatment must be individualized. CONCLUSION: We have outlined the treatment of carcinoma of the vulva at our Centre, over a 10-year period.

Bulgaria↗
PubMed2006

[A case of inflammatory myofibroblastic tumor of the urinary bladder finally diagnosed by anaplastic lymphoma kinase (ALK) immunostaining].

A 52-year-old house wife presented with pain on urination. Cystoscopy and magnetic resonance imaging revealed solid and sessile tumor of 3 cm in diameter invading the bladder wall. Pathological examination of the transurethral resection specimen showed proliferation of spindle cells and epithelial cells. Since both types of cells were positive for cytokeratin immunostaining, sarcomatoid carcinoma was highly suspected. She underwent anterior pelvic exenteration and construction of continent reservoir (Penn Pouch). Since the tumor cells showed spindle cell proliferation alone without epithelial growth and positive staining for anaplastic lymphoma kinase, we corrected the final diagnosis as an inflammatory myofibroblastic tumor of the urinary bladder. She has been doing well without recurrence for 1 year.

Anaplastic Lymphoma Kinase↗
PubMed2003

[Intestinal gas explosion during operation: a case report].

A case of intestinal gas explosion during the course of carcinologic surgery in a 51-year-old patient is reported. This accident, often dramatic, has become exceptional since the use of mannitol for colonic preparation has disappeared. This incident occurred during the course of a total pelvic exenteration performed under general anaesthesia with inhalation of both a mixture oxygen-nitrous oxide and volatile agents. The colon incision with an electrocautery was contemporaneous with a violent deflagration accountable for organic lesions. This case report reminds us that the risk of a dangerous explosion persists in relation with surgical, anaesthetic and individual risk factors.

Adenocarcinoma↗
PubMed2005

Surgery for locally recurrent rectal cancer.

PURPOSE: Resection of locally recurrent rectal cancer after curative resection represents a difficult clinical problem and a surgical challenge. The aim of this study was to assess the outcome of a series of patients who underwent resection of locally recurrent rectal cancer with curative intent. METHODS: A retrospective review was performed of 64 patients who underwent surgical exploration with a view to cure for locally recurrent rectal cancer under the care of one surgeon between April 1997 and April 2004. Details were obtained on the primary tumor and the operation, the indication for investigation of recurrence, preoperative imaging, operative findings, morbidity and mortality, and histopathology. RESULTS: The median time interval between resection of primary tumor and surgery for locally recurrent disease was 31 (interquartile range, 21 to 48) months. Twenty-three patients had central disease, 10 patients had sacral involvement, 21 patients had pelvic sidewall involvement, and 10 patients had both sacral and sidewall involvement. Fifty-seven patients underwent resection of the tumor. Thirty-nine of the 57 patients underwent wide resection (abdominoperineal excision of rectum, anterior resection, or Hartmann's procedure) whereas 18 patients (31.6 percent) required radical resection (pelvic exenteration or sacrectomy). Curative, negative resection margins were obtained in 21 of 57 patients who had tumor excision (36.8 percent). Perioperative mortality was 1.6 percent. Significant postoperative morbidity occurred in 40 percent of patients. CONCLUSIONS: This study has shown that a significant proportion of patients with locally recurrent rectal cancer can undergo resection with negative margins.

Adenocarcinoma↗
PubMed1987

Gastrointestinal surgery in gynecologic oncology: evaluation of surgical techniques.

In recent years, the use of surgical staples has become popular in all subspecialties of surgery. The advantages proposed have been a decrease in operative time and morbidity. This paper reviews the University of Miami/Jackson Memorial Medical Center, Division of Gynecologic Oncology experience with the use of surgical staples in gastrointestinal surgery on patients with a diagnosis of a gynecologic malignancy. Between January 1, 1979 and July 1, 1985, a total of 152 procedures were done, 81 by stapler and 71 by suture anastomosis. Ninety-one patients had received previous radiation or chemotherapy. The average age of the patients was 52 years. The results show a decrease in operating time, blood loss, and postoperative hospital stay in those patients where the stapler anastomosis was used. The postoperative morbidity and mortality were not increased. Twenty-seven total pelvic exenterations were performed during the period of study and they were evaluated separately. The hospital stay and blood loss as well as the operative time were significantly less using staplers. This report includes a detailed evaluation of the results. From this study, we concluded that surgical staples are a safe alternative in gastrointestinal surgery in patients with a gynecologic malignancy.

Adult↗
PubMed1989

Short gracilis myocutaneous flaps for vulvovaginal reconstruction after radical pelvic surgery.

The short gracilis myocutaneous flap derives its blood supply from terminal branches of the obturator artery, and the vascular pedicle derived from the medial femoral circumflex artery is sacrificed. Twenty-one short gracilis myocutaneous flaps were used for vulvovaginal reconstructions in 11 patients undergoing radical pelvic surgery: bilateral flaps in nine patients for neovaginal construction after pelvic exenterations, bilateral flaps in one patient for vulvovaginal reconstruction after radical vulvovaginectomy, and a unilateral flap in one patient for vulvovaginal reconstruction after radical vulvectomy with partial vaginectomy. Major complications consisted of bilateral flap necrosis occurring in one patient who had received preoperative irradiation to the vulva and groin combined with chemotherapy. Minor degrees of necrosis (less than 5%) and/or separation of vaginal suture lines occurred in five patients without marked loss of the flaps. Vaginal caliber and depth are excellent in ten patients (91%) after follow-up of 1-22 months. The short gracilis flap is an excellent alternative to the more bulky gracilis flap, which derives its blood supply from perforating branches of the femoral artery. Based on our experience, the short gracilis flap provides adequately vascularized tissue for vulvovaginal reconstruction in patients after radical pelvic surgery, but should not be used in patients who have received extensive groin irradiation.

Adult↗
PubMed1992

[Leiomyosarcomas of the rectum. Amputation of the rectum or local resection?].

Two cases of high grade leiomyosarcoma of the rectum treated by local excision are reported. The first patient presented a local recurrence associated with liver and pulmonary metastases and eventually died, respectively 11 and 22 months after resection. The second patient's tumor recurred 3 months after excision and was treated with pelvic exenteration and CYVADIC regimen as chemotherapy and died 3 years later from local recurrence. A review of the literature indicates that local surgical excision in comparison to a more radical surgical approach, such as abdominoperineal resection, is as effective in improving survival. Lesions less than 2.5 cm in diameter, confined to the bowel can be treated by local surgical excision. To date no adjuvant therapy is effective in terms of survival or local control.

Female↗