Department of Digestive Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
Colorectal Dis. 2019 Nov;21(11):1321-1325. doi: 10.1111/codi.14737. Epub 2019 Jul 9.
Empty pelvis syndrome and radiation-induced bowel injury are two major clinical issues resulting from the pelvic dead space after pelvic exenteration (PE). In order to avoid these complications, different methods of pelvic floor reconstruction have been proposed. We report our experience on the use of breast prosthesis.
Fifty-three patients who underwent PE and three who underwent palliative surgery with silicone breast prosthesis placement were included.
Forty-seven posterior PE, six total PE and three palliative procedures were identified. Sphincter preservation was feasible in 34 patients (62.3%). There were no deaths. Overall morbidity was 37.5%. There were no complications such as sepsis or obstruction related to the prosthesis. Adjuvant radiotherapy was delivered in 16 cases (30.1%) without any side-effects. Reconstruction of intestinal continuity was possible in 12 patients (36.3%) with sphincter preservation and the prosthesis allowed a prompt identification of the rectal stump.
Breast prosthesis placement is a simple and safe method to minimize complications resulting from empty pelvis syndrome and can be adopted to exclude bowel loops from the radiation field. Reconstruction of intestinal continuity after resection is also simplified.
骨盆切除术后出现骨盆死腔，可导致空盆综合征和放射性肠损伤，这是两个主要的临床问题。为避免这些并发症，提出了各种不同的盆底重建方法。我们报告使用乳房假体的经验。
53 例患者接受了骨盆切除术，3 例接受了姑息性手术并放置了硅胶乳房假体。
确定了 47 例后盆切除术、6 例全盆切除术和 3 例姑息性手术。34 例患者（62.3%）可行肛门括约肌保留。无死亡病例。总发病率为 37.5%。与假体相关的无感染或梗阻等并发症。16 例（30.1%）患者接受了辅助放疗，无任何副作用。12 例（36.3%）保留肛门括约肌且放置假体的患者可重建肠连续性，假体可迅速识别直肠残端。
乳房假体放置是一种简单、安全的方法，可最大程度地减少空盆综合征引起的并发症，并且可以采用该方法将肠袢排除在放射野之外。切除后重建肠连续性也得到简化。
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