Dottino P R, Segna R A, Jennings T S, Mandeli J P, Konsker K, Cohen C J
Department of Obstetrics, Gynecology and Reproductive Sciences, Mount Sinai Medical Center, New York, NY 10029, USA.
Mt Sinai J Med. 1995 Nov;62(6):431-5.
Thirty-nine patients underwent pelvic exenteration for gynecologic malignancies at The Mount Sinai Medical Center between 1975 and 1992. Surgical techniques, morbidity, survival, and other variables for patients so treated in two periods, 1975-1984 and 1985-1992, were compared. The primary cancer included squamous cell carcinoma of the cervix, 27; adenocarcinoma of the cervix, 1; squamous cell carcinoma of the vagina, 4; adenocarcinoma of the endometrium, 4; squamous cell carcinoma of the vulva, 2; and adenocarcinoma of the rectum, 1. Median survival was 23.1 months, with a median follow-up of 18 months. Survival was significantly related to status of the lymph nodes (p 0.0004) and surgical margins (p 0.0038). There were two postoperative mortalities, one due to pulmonary embolus and another to myocardial infarction. The ability in the second period analyzed, 1985-1992, to integrate a continent urinary reservoir and supralevator exenteration without colostomy yet not induce increased morbidity or decreased survival, has not been previously reported.
1975年至1992年间，39例患者在西奈山医学中心因妇科恶性肿瘤接受了盆腔脏器清除术。对1975 - 1984年和1985 - 1992年这两个时期接受该治疗的患者的手术技术、发病率、生存率及其他变量进行了比较。原发性癌症包括子宫颈鳞状细胞癌27例；子宫颈腺癌1例；阴道鳞状细胞癌4例；子宫内膜腺癌4例；外阴鳞状细胞癌2例；直肠腺癌1例。中位生存期为23.1个月，中位随访时间为18个月。生存率与淋巴结状态（p = 0.0004）和手术切缘（p = 0.0038）显著相关。术后有2例死亡，1例死于肺栓塞，另1例死于心肌梗死。在1985 - 1992年分析的第二个时期，能够整合可控性尿流改道术和经肛提肌外盆腔脏器清除术而无需结肠造口，且不增加发病率或降低生存率，此前尚未见报道。
