[Posterior pelvic exenteration in the treatment of extraperitoneal rectal cancer in females].

Postoperative recurrence is common in the, posterior vaginal wall and intrapelvic genital organs after conventional Mile's operation for extraperitoneal rectal cancer in female patients. We have performed posterior pelvic exenteration (PPE) since 1954 in an attempt to reduce such recurrences. The results of 208 patients treated by PPE were compared with those of 77 patients treated by conventional Mile's operation during 1954-1986. The 5-year survival rate of PPE was 53.15 +/- 1.87% and that of Mile's operation was 51.84 +/- 1.68%; the increase was not significant as more cases of poorer prognosis were selected for PPE. However, the local recurrence rate was lower after PPE than after conventional Mile's operation (4.33%:20.78%), (P less than 0.01). We believe that PPE is indicated in anterior rectal lesions of Dukes A, B or C stage, ulcerative or infiltrative type, or when the recto-uterine pouch is involved. PPE will not increase the operative risk if close attention is paid to hemostasis, facilitated by clamping cutting and suture ligating the lateral vaginal wall in segments.