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Khirurgiia (Mosk) 2022 (7):45-57

Sechenov First Moscow State Medical University, Moscow, Russia.

Objective: To analyze clinical outcomes after pelvic exenteration for advanced primary or recurrent pelvic cancer.

Material And Methods: We analyzed the outcomes in 35 patients after pelvic exenteration for advanced primary or recurrent pelvic cancer (gynecological cancer, urologic cancers, colon cancer). There were 3 (8. Read More

Eur J Surg Oncol 2022 Jun 16. Epub 2022 Jun 16.

Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Purpose: The aim of this study was to clarify the suitable radial margin (RM) for favourable outcomes after pelvic exenteration (PE), focusing on the discrepancy between the concepts of circumferential resection margin (CRM) and traditional R status.

Methods: Seventy-three patients with locally advanced (LARC, n = 24) or locally recurrent rectal cancer (LRRC, n = 49) who underwent PE between 2006 and 2018 were retrospectively analysed. Patients were histologically classified into the following 3 groups; wide RM (≥1 mm, n = 45), narrow RM (0-1 mm, n = 10), and exposed RM (n = 18). Read More

Colorectal Dis 2022 Jun 29. Epub 2022 Jun 29.

Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia.

Background: Pelvic exenteration (PE) has become the standard of care for locally advanced and recurrent rectal cancer. The high short term morbidity reported from this procedure is well established, however, longer term complications of such radical surgery and their management have not been fully addressed. This study aimed to investigate the incidence, indications and outcomes of long-term (more than 90 day) re-operative surgery in this group of patients, with a focus on the empty pelvis syndrome (EPS). Read More

Front Oncol 2022 9;12:898060. Epub 2022 Jun 9.

Unità Operativa Complessa (UOC) Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

This study provides a detailed description of the new HUGO™ RAS System and suggests docking settings for gynecological surgery. The system is composed of an "open" surgical console with an HD-3D passive display, a system tower, and four arm carts. Each arm has an extremely wide range of adaptability resulting from the numerous joints. Read More

Obstet Gynecol Sci 2022 Jun 27. Epub 2022 Jun 27.

Department of Obstetrics and Gynecology, Dongguk University College of Medicine, Goyang, Korea.

Objective: This study aims to evaluate the safety and feasibility of laterally extended endopelvic resection (LEER) for sarcoma in the female genital tract.

Methods: We prospectively recruited gynecologic cancer patients with sarcoma arising from female genital tract who underwent LEER at Seoul National University Hospital from December 2016 to March 2021. Clinicopathologic characteristics, surgical outcomes including postoperative complications and pain control, and survival outcomes of the patients were investigated. Read More

Int J Colorectal Dis 2022 Jun 25. Epub 2022 Jun 25.

Department of General and Visceral Surgery, Dresden-Friedrichstadt General Hospital, Teaching Hospital of the Technical University of Dresden, Friedrichstr. 41, Dresden, D-01067, Germany.

Purpose: No standard exists for reconstruction after extralevator abdominoperineal excision (ELAPE) and pelvic exenteration. We propose a tailored concept with the use of bilateral gluteal V-Y advancement flaps in non-extended ELAPE and with vertical myocutaneous rectus abdominis muscle (VRAM) flaps in extended procedures. This retrospective study analyzes the feasibility of this concept. Read More

Hinyokika Kiyo 2022 May;68(5):155-159

The Department of Digestive Surgery and Transplantation, Tokushima University Graduate School of Biomedical Sciences.

We describe two cases of locally advanced rectal cancer (LARC) treated with robot-assisted total pelvic exenteration (Ra-TPE) and intracorporeal ileal conduit (ICIC). The first case was in a 71-year-old man with LARC (RbP, T4bN2bM0, cStage IIIc). He was started on bevacizumab+S-1/oxaliplatin therapy in July 2019. Read More

Colorectal Dis 2022 Jun 22. Epub 2022 Jun 22.

Complex Cancer Clinic, St Mark's Hospital and Academic Institute, Watford Rd, Harrow HA1 3UJ.

Surg Case Rep 2022 Jun 20;8(1):116. Epub 2022 Jun 20.

Department of Gastroenterological Surgery, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.

Introduction: Surgery for anal fistula cancer (AFC) associated with Crohn's disease usually entails extensive perineal wounds and dead space in the pelvis, which is often filled with a myocutaneous flap. However, use of a myocutaneous flap is invasive. We report a case of total pelvic exenteration (TPE) for AFC in which a myocutaneous flap was avoided by using an omental flap and negative pressure wound therapy (NPWT). Read More

BMJ Open 2022 Jun 15;12(6):e056984. Epub 2022 Jun 15.

Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK.

Introduction: Approximately 5%-10% of new rectal cancers are locally advanced (locally advanced rectal cancer (LARC)) at presentation with 4%-8% recurring (locally recurrent rectal cancer (LRRC)) after initial treatment. Patients with potentially curable disease have to consider many trade-offs when considering major exenterative surgery. There are no decision tools for these patients and current resources have found to not meet minimum international standards. Read More

Asian J Surg 2022 Jun 9. Epub 2022 Jun 9.

Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, No. 950 Donghai Street, Fengze District, Quanzhou, 362000, Fujian Province, China. Electronic address:

Can J Urol 2022 Jun;29(3):11194-11197

Division of Urology, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland, USA.

Total pelvic exenterations (TPE) are high morbidity procedures, with up to 38% of patients experiencing a major complication after TPE surgery. We report the case of a 69-year-old woman with a sigmoid conduit-neovaginal fistula who presented with new onset continuous vaginal leakage and decreased urostomy output 3 months post-op from a TPE. We highlight the presentation, diagnosis, conservative management, and surgical management of conduit-vaginal fistulas. Read More

Int Cancer Conf J 2022 Jul 7;11(3):215-218. Epub 2022 May 7.

Department of Urology, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi-Hirokoji, Kyoto, 602-8566 Japan.

A 23-year-old man presented with complaints of macrohematuria and hematospermia and was referred to our hospital for further examination. Magnetic resonance imaging revealed a round 30 × 25 mm tumor in the right peripheral zone; hence, a rare prostate tumor was suspected. Grayscale transrectal ultrasonography (TRUS) was performed using the Aplio-i800 PVL-715RST-transducer and revealed a well-defined round tumor. Read More

Surg Case Rep 2022 Jun 2;8(1):107. Epub 2022 Jun 2.

Division of Lower G.I., Department of Gastroenterological Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.

Background: In Japan, Crohn's disease (CD)-related cancers occur most frequently in the anal canal. Many patients with advanced CD-related cancer require total pelvic exenteration (TPE) based on their medical history, and choosing the most effective method for urinary diversion is a major concern. We herein report the first case of CD-related cancer treatment with urinary diversion using a gastric conduit after TPE in Japan. Read More

Colorectal Dis 2022 Jun 2. Epub 2022 Jun 2.

Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

Aim: As the "empty pelvis syndrome" continues to pose challenges in patients undergoing radical pelvic exenteration, there remains an ongoing need to consider solutions to mitigate or avoid its associated morbidity. As such, this study aims to review the long-term outcomes of a proposed strategy of pelvic reconstruction with BioA mesh.

Method: We conducted a retrospective observational cohort study, reviewing cases of pelvic exenteration and/or pelvic bone resection involving BioA mesh pelvic reconstruction between 2017 and 2021 at our quaternary institution, identified from a prospectively collected database. Read More

Gynecol Oncol Rep 2022 Jun 23;41:101004. Epub 2022 May 23.

Department of Obstetrics and Gynecology, Democritus University of Thrace, 6th klm Alexandroupolis-Makris, Dragana, 68100 Alexandroupolis, Greece.

Introduction: Collision tumors are characterized by the coexistence of two adjacent, but histologically distinct tumors. This entity can occur between tumors originating from the same organ or between metastases from other sites.

Case Presentation: A 49-year-old postmenopausal female with abnormal vaginal bleeding and abdominal pain was diagnosed with two coexistent tumors, a grade 1 endometrioid carcinoma and a pT2 undifferentiated stromal sarcoma (USS). Read More

J Obstet Gynaecol Res 2022 Jul 20;48(7):1904-1912. Epub 2022 May 20.

Department of Gynecologic Oncology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.

Objective: To evaluate the open abdomen technique (laparostomy) used in complications of major gynecological oncology surgery.

Methods: We analyzed retrospectively the surgical database of all patients who had undergone major open surgery by the same gynecologic oncologist over a 5-year period. All patients who had had open abdomen procedure were identified; demographic data and indications of primary surgery, temporary abdominal closure procedure details, fascia closure and morbidity, mortality rates were evaluated. Read More

BJS Open 2022 05;6(3)

Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan.

Background: Rectal gastrointestinal stromal tumours (GISTs) are rare and treated mainly by radical surgery. Although the importance of perioperative imatinib has been recognized, there are few reports on its outcomes.

Method: Consecutive patients diagnosed with rectal GISTs between July 2008 and February 2021 were identified from a prospective database. Read More

Urology 2022 May 16. Epub 2022 May 16.

Division of Urology, Albany Medical Center, Albany, NY.

Objective: To investigate the impact of pelvic exenteration (PelvEX) on patient-reported pain, distress, and quality of life along with physiologic indicators of health in cancer survivors with radiated, non-repairable rectourethral fistula (RUF).

Materials And Methods: We reviewed a prospectively maintained quality improvement database of RUF patients at our institution from 2012 to 2020. Patients with radiated, non-repairable RUF who underwent PelvEX and had follow up to 1 year were included. Read More

Eur J Obstet Gynecol Reprod Biol 2022 Jul 11;274:56-61. Epub 2022 May 11.

Academic Department of Gynaecological Oncology, Royal Surrey NHS Foundation Trust, Surrey, UK. Electronic address:

For those with certain recurrent gynaecological cancers where primary management such as chemo-radiotherapy has failed, or in cases of recurrence following primary surgery, pelvic exenteration (PE) is considered the only curative option. Whilst initially considered a morbid procedure, improved surgical techniques, advancing technology, and nuanced reconstructive options have facilitated more radical resections and improved morbidity and mortality. Open PE remains the gold standard approach, however, minimally invasive techniques for PE may lessen morbidity whilst achieving the same oncological outcomes. Read More

Tech Coloproctol 2022 May 16. Epub 2022 May 16.

Department of Gastrointestinal Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Transl Cancer Res 2022 Apr;11(4):943-951

Department of Radiation Oncology, The Second Affiliated Hospital of Jilin University, Changchun, China.

Background: Despite the availability of multiple treatments, the prognosis of recurrent cervical cancer (RCC) remains poor. There are no reports of the entire treatment of cases with multiple recurrences, and clinicians have no guidelines in such cases. We share our experience and consider this complex case of multiple recurrences of cervical cancer. Read More

Gynecol Oncol 2022 Jul 12;166(1):100-107. Epub 2022 May 12.

Gynaecologic oncology centre, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.

Background: The aim of the study was to compare health-related quality of life (QoL) and oncological outcome between gynaecological cancer patients undergoing pelvic exenteration (PE) and extended pelvic exenteration (EPE). EPEs were defined as extensive procedures including, in addition to standard PE extent, the resection of internal, external, or common iliac vessels; pelvic side-wall muscles; large pelvic nerves (sciatic or femoral); and/or pelvic bones.

Methods: Data from 74 patients who underwent PE (42) or EPE (32) between 2004 and 2019 at a single tertiary gynae-oncology centre in Prague were analysed. Read More

Cancers (Basel) 2022 May 9;14(9). Epub 2022 May 9.

First Obstetrics and Gynecology Clinic, University of Medicine, Pharmacy, Science and Technology "G.E. Palade" of Târgu Mureș, Gheorghe Marinescu Street, Number 38, 540142 Târgu Mureș, Romania.

Background: Considerable efforts have been carried out over the past 30 years to support patients with advanced cervical cancer. Throughout this time, Eastern European countries have been left aside from the decision-making groups on this matter, hence the absence of similar studies in this geographical area. In these countries, the quality of life (QoL) of patients with cervical cancer might be considered a "caprice", and the discomforts they encounter following pelvic exenteration for cervical cancer are often perceived as a "normal phenomenon". Read More

Colorectal Dis 2022 May 12. Epub 2022 May 12.

Department of Gastrointestinal Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Cancer Diagn Progn 2022 May-Jun;2(3):308-315. Epub 2022 May 3.

Department of Gynecology, Gynecological Oncology and Gynecological Endocrinology, University Hospital of Giessen and Marburg (UKGM), Marburg, Germany.

Background/aim: Cervical cancer is the most common gynecological indication for pelvic exenteration (PE). It is an ultima ratio approach to cure advanced or recurring tumors. This study aimed to evaluate data from a Single Center Institution in order to assess morbidity, mortality and survival data. Read More

Dis Colon Rectum 2022 May 4. Epub 2022 May 4.

Division of Urologic Surgery, Duke University Medical Center, Durham, NC.

Background: Rectourethral fistulas are a rare yet severe complication of prostate surgery, pelvic irradiation, or both. Multiple surgical repairs exist with widely varying success rates.

Objective: To present our institution's multidisciplinary algorithm for rectourethral fistula repair and its outcomes. Read More

ANZ J Surg 2022 May 3. Epub 2022 May 3.

Colorectal Unit, Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

Backgrounds: Locally invasive T4 rectal cancer often requires neoadjuvant treatment followed by multi-visceral surgery to achieve a radical resection (R0), and referral to a specialized exenteration quaternary centre is typically recommended. The aim of this study was to explore regional variance in treatment and outcomes of patients with locally advanced rectal cancer in Australia and New Zealand (ANZ).

Methods: Data were collected from the Bi-National Colorectal Cancer Audit (BCCA) database. Read More

ANZ J Surg 2022 May 1. Epub 2022 May 1.

Department of General Surgery, Christchurch Hospital, Christchurch, New Zealand.

Management of advanced or recurrent pelvic cancer has evolved dramatically over the past few decades. Patients who were previously considered inoperable are now candidates for potentially curative surgery and avoid suffering with intractable symptoms. Up to 10% of primary rectal cancers present with isolated advanced local disease and between 10% and 15% of patients develop localized recurrence following proctectomy. Read More

Gynecol Oncol 2022 Jun 26;165(3):514-521. Epub 2022 Apr 26.

H. Lee Moffitt Cancer Center, Department of Gynecologic Oncology, United States of America. Electronic address:

Objective: To determine the effect of distance to closest negative margin on survival after pelvic exenteration (PE).

Methods: In this retrospective analysis of PE at Moffitt Cancer Center from 2000 to 2019, baseline characteristics, clinical details, and outcomes were ascertained. Distance to closest negative margin was measured. Read More