Stîngu C, Mitulescu G, Ungureanu C, Popescu I
Centrul de Chirurgie Generală şi Transplant Hepatic, Institutul Clinic Fundeni, Bucureşti.
Chirurgia (Bucur). 2007 Jul-Aug;102(4):389-99.
Total pelvic exenteration leaves a major defect in pelvic-perineal region. Delayed healing, bowel fistulae, occlusion or protrusion and infection are frequent complications of this procedure. During 2000-2006, in General Surgery and Liver Transplantation Fundeni, 73 patients with advanced pelvic cancer and invasive recurrences were operated. For 42 patients, various procedures for pelvic and vaginal reconstruction (omental flap, muscular and musculo-cutaneous flaps--rectus abdominis and gracilis) were performed in order to fill the pelvi-perineal defects and restore form and function. Technical principles, indications, contraindications, advantages and disadvantages of these procedures are outlined. We found that complications related to total pelvic exenteration dramatically decreased and primary healing of the perineal wound was superior, facts that correlate with the literature data.
全盆腔脏器切除术会在盆腔 - 会阴区域留下一个大的缺损。愈合延迟、肠瘘、堵塞或突出以及感染是该手术常见的并发症。在2000年至2006年期间,在Fundeni普通外科和肝移植科,对73例晚期盆腔癌和侵袭性复发患者进行了手术。对于42例患者,实施了各种盆腔和阴道重建手术(网膜瓣、肌肉瓣和肌皮瓣——腹直肌和股薄肌),以填补盆腔 - 会阴缺损并恢复形态和功能。概述了这些手术的技术原则、适应证、禁忌证、优点和缺点。我们发现与全盆腔脏器切除术相关的并发症显著减少,会阴伤口一期愈合情况更好,这些事实与文献数据相符。