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Colorectal function preservation in posterior and total supralevator exenteration for gynecologic malignancies: an 89-patient series.

Abstract：

OBJECTIVE:The objective of this study was to analyze our experience with colorectal function preservation at the time of pelvic exenteration. METHODS:Between January 1980 and December 2001, 201 pelvic exenterations for gynecologic malignancies were performed in our hospital. Ninety-eight were supralevator exenterations and 89 were selected for this study because low colorectal anastomosis (LCRA) was performed. There were locally advanced or recurrent cancers including 50 cervical, 28 ovarian, 11 endometrial, and 3 vaginal malignancies and 5 pelvic sarcomas. RESULTS:Thirty-nine patients (44%) had a history of previous irradiation. There were were 50 posterior and 39 total exenterations. A diverting stomy and/or pelvic filling were performed respectively in 44 (49.4%) and 26 (29%) cases. The postoperative mortality rate was 4.5% (4/89). Seventeen patients experienced a colorectal anastomotic fistula (AF). AF occurred significantly more frequently in irradiated patients (14/17 = 82%). The mortality rate related to AF was 6% (1/17). Ultimately the functional colorectal anastomosis rate was 71.9%, respectively 61.5 and 80% in irradiated and nonirradiated patients. CONCLUSIONS:Colorectal function preservation in supralevator exenteration for gynecologic malignancies can be achieved safely in a majority of patients. In irradiated patients a systematically diverting stomy may result in a low mortality rate.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Moutardier V,Houvenaeghel G,Lelong B,Mokart D,Delpero JR

doi

10.1016/s0090-8258(03)00069-6

subject

Has Abstract

pub_date

2003-04-01 00:00:00

pages

155-9

issue

1

eissn

0090-8258

issn

1095-6859

pii

S0090825803000696

journal_volume

89

pub_type

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