Vitelli C E, Crenca F, Fortunato L, Di Nardo A, Farina M, Mustacciuoli G
Division of General and Oncologic Surgery, M. G. Vannini Hospital, Via Acqua Bullicante 4, I-00177, Rome, Italy.
Tech Coloproctol. 2003 Oct;7(3):159-63. doi: 10.1007/s10151-003-0028-2.
We describe our experience with exenterative pelvic surgery for colorectal cancer in a small community hospital.
We retrospectively evaluated 26 consecutive patients (14 women) with locally advanced (n=16) or recurrent (n=10) colorectal adenocarcinomas who underwent pelvic exenterations between August 1990 and December 2001 in our service.
Seventeen patients had posterior pelvic exenteration (PPE), eight had total pelvic exenteration (TPE) and one had TPE with internal hemipelvectomy. Major morbidity occurred in 12 patients (46%), causing 3 deaths (11%) in the immediate postoperative period. Fourteen of 23 patients who survived the immediate postoperative period have relapsed (61%). At a median follow-up of 42 months, the 5-year survival is 38%.
Pelvic exenterative procedures can be offered to patients with bulky or recurrent colorectal carcinomas with adequate results and satisfactory palliation, even in a community setting.
我们描述了在一家小型社区医院进行的结直肠癌盆腔脏器清除术的经验。
我们回顾性评估了1990年8月至2001年12月期间在我们科室接受盆腔脏器清除术的26例连续患者（14名女性），这些患者患有局部晚期（n = 16）或复发性（n = 10）结肠直肠腺癌。
17例患者接受了后盆腔脏器清除术（PPE），8例接受了全盆腔脏器清除术（TPE），1例接受了TPE联合半骨盆切除术。12例患者（46%）发生了严重并发症，导致术后早期3例死亡（11%）。术后早期存活的23例患者中有14例复发（61%）。中位随访42个月时，5年生存率为38%。
对于患有体积较大或复发性结肠直肠癌的患者，即使在社区环境中，也可以提供盆腔脏器清除术，其结果良好且姑息效果令人满意。
