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Complications of Pelvic Exenteration

James G. Jakowatz, MD; David Porudominsky, MD; Daniel U. Riihimaki, MD; Margaret Kemeny, MD; William A. Kokal, MD; Patricia S. Braly, MD; José J. Terz, MD; J. David Beatty, MD
Arch Surg. 1985;120(11):1261-1265. doi:10.1001/archsurg.1985.01390350043009.
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• This report is based on a retrospective review of 104 patients who had undergone pelvic exenteration for advanced malignancy over a 29-year period (1956 to 1984, inclusive). Fifty-one patients (49%) developed major complications of the operative field involving the gastrointestinal tract (fistula or obstruction), the urinary tract (fistula, infection, or obstruction), or the wound (abscess, dehiscence/necrosis, or hemorrhage). No association was identified between the complication rate and organ of primary disease, extent of disease, tumor histology, or extent of resection. Patients receiving pelvic radiotherapy prior to exenteration had a much higher complication rate (39/58, 67%) than patients having had no radiotherapy (12/46, 26%). Reconstruction of the irradiated pelvis after exenteration by omental flap, colonic advancement, and/or myocutaneous flaps decreased the complication rate from 82% (27/33) to 48% (12/25). The operative mortality of pelvic exenteration was 2.9% and the actuarial five-year survival rate was 27%.

(Arch Surg 1985;120:1261-1265)


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