2,823 results match your criteria: "Pelvic Exenteration"
Computational Pathology-Enabled Residual Tumor Estimation is a Prognostic Factor for Overall Survival in Anal Squamous Cell Carcinoma.
Mod Pathol
December 2024
Department of Pathology, Cleveland Clinic, Cleveland, OH. Electronic address:
Anal squamous cell carcinoma (SCC) incidence has increased, and treatment has shifted from surgery to chemoradiotherapy (CRT), with salvage abdominoperineal resection (APR) being reserved for persistent/recurrent cases. This study evaluates the utility of different Tumor Regression Scoring Systems (TRSS) in predicting survival in anal SCC patients, using pathologists' observations and digital pathology. Cases managed surgically from 2005 to 2019 were collected.
View Article and Find Full Text PDFCurrent Management of Locally Recurrent Rectal Cancer.
Cancers (Basel)
November 2024
UOC Chirurgia Digestiva e del Colon-Retto, Ospedale Isola Tiberina Gemelli Isola, 00186 Rome, Italy.
Locally recurrent rectal cancer (LRRC), which occurs in 6-12% of patients previously treated with surgery, with or without pre-operative chemoradiation therapy, represents a complex and heterogeneous disease profoundly affecting the patient's quality of life (QoL) and long-term survival. Its management usually requires a multidisciplinary approach, to evaluate the several aspects of a LRRC, such as resectability or the best approach to reduce symptoms. Surgical treatment is more complex and usually needs high-volume centers to obtain a higher rate of radical (R0) resections and to reduce the rate of postoperative complications.
View Article and Find Full Text PDFPriority outcomes of pelvic exenteration for rectal cancer: a patient, carer, and clinician consensus.
Br J Surg
November 2024
Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
A matter of survival-patients' and carers' perspectives on the decision to undergo pelvic exenteration surgery for locally advanced and recurrent rectal cancer.
Colorectal Dis
December 2024
Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Aim: Pelvic exenteration is the only potentially curative treatment for patients with locally advanced or recurrent rectal cancer. This study aimed to investigate how patients decide to undergo such radical surgery.
Method: This qualitative study employed an exploratory interpretive design informed by hermeneutic philosophy.
Case Report: Combined Laparoscopic Perineal Hernia and Abdominal Parastomal Hernia Repair With a Mesh After Abdominoperineal Resection: A Video Vignette and Review of the Literature.
J Abdom Wall Surg
November 2024
Department of General Surgery, ASST Nord Milano, Milano, Italy.
Background: Postoperative perineal hernia (PH) is an uncommon complication after abdominoperineal resection (APR). Different techniques have been described in literature and there is no consensus regarding the optimal repair approach. In the present study, we reported a case of a laparoscopic combined repair of a perineal hernia and abdominal parastomal hernia (PSH) with mesh.
View Article and Find Full Text PDFAdvances in beyond total mesorectal excision surgery: Behind the scenes.
World J Gastrointest Surg
November 2024
Department of Public Health, University of Naples Federico II, Napoli 80131,
Article Synopsis
- - The management of locally advanced rectal cancer has improved significantly over the years, particularly in preoperative treatments and surgical techniques.
- - The increasing use of robotic platforms and minimally invasive procedures, including complex surgeries like pelvic exenteration, enhances surgical outcomes.
- - Successful results depend on a multidisciplinary team approach that emphasizes skilled surgeons, surgical oncology principles, proper medical treatments, careful preoperative planning, and maintaining a good quality of life.
ASO Author Reflections: High Rate of Positive Surgical Margins Following Pelvic Exenteration in the USA: A Call to Action.
Ann Surg Oncol
December 2024
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
Survival Outcomes in Patients Undergoing Pelvic Exenteration for Pelvic Mucosal Melanomas: Retrospective Single Institution Australian Study.
Dis Colon Rectum
December 2024
Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia.
Background: Pelvic mucosal melanomas, including anorectal and urogenital melanomas, are rare and aggressive with a median overall survival of up to 20 months. Pelvic mucosal melanomas behave differently to its cutaneous counterparts and presents late with locoregional disease, making pelvic exenteration its only curative surgical option.
Objective: This study aimed to evaluate the survival outcomes post pelvic exenteration in pelvic mucosal melanomas at Royal Prince Alfred Hospital.
Socioeconomic and Racial Disparities in the Use of Robotic-Assisted Proctectomy in Rectal Cancer.
Am Surg
December 2024
Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
Article Synopsis
Patterns of Care and Oncologic Outcomes after Pelvic Exenteration for Locally Advanced Rectal Cancer in the United States.
Ann Surg Oncol
December 2024
Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
Article Synopsis
- Pelvic exenterations (PEs) are complex surgeries aimed at treating advanced rectal cancer, with the study focusing on national patterns and outcomes instead of single-center data.* -
- From 673 patients, 76% received neoadjuvant chemotherapy and 24% had positive margins after surgery; younger age and post-surgery chemotherapy improved overall survival, while positive margins worsened prognosis.* -
- The study concluded that a significant portion of patients had positive resections, highlighting the importance of achieving negative margins in surgical procedures for better patient outcomes.*
A radiologist's guide to the galaxy of complications post total pelvic exenteration for rectal cancers.
Clin Radiol
October 2024
Department of Radio-diagnosis, Tata Memorial Hospital, Parel, Mumbai, 400012, India; Homi Bhabha National Institute, Anushakti Nagar, Trombay, 400094, India.
Article Synopsis
- - Total pelvic exenteration (TPE) is a complex surgical procedure that may be the sole curative option for patients with advanced rectal cancers, resulting in lifelong management of two permanent stomas.
- - There is a knowledge gap among radiologists regarding the complications that can arise after TPE surgery, leading to potential misdiagnosis or overlooked symptoms that could have serious consequences.
- - The article aims to enhance understanding of postoperative pelvic anatomy, highlight early and delayed complications, and provide guidance on imaging techniques to accurately diagnose issues related to TPE through illustrative case studies.
[Clinical application of reconstruction of pelvic floor with pedunculated omentum flap combined with basement membrane biological products in pelvic exenteration with sacrococcygeal bone].
Zhonghua Wei Chang Wai Ke Za Zhi
November 2024
Department of Colorectal Surgery, the Second Affiliated Hospital of Naval Medical University, Shanghai200003, China.
Article Synopsis
Open versus robotic-assisted techniques for multivisceral pelvic resections of locally advanced or recurrent colorectal and anal cancers: short-term outcomes from a single centre.
Tech Coloproctol
November 2024
Department of Colorectal Surgery, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L7 8XP, UK.
Background: Pelvic exenterations are now established as a standard of care for locally advanced and recurrent rectal cancer. Traditionally, these radical and complex operations have been performed via an open approach, but with the increasing expertise in robotic-assisted surgery (RAS), there is scope to perform such cases robotically. This study compares outcomes from open and RAS pelvic exenterations.
View Article and Find Full Text PDFA pedicled anterolateral thigh flap decreased the risk of empty pelvis syndrome following total pelvic exenteration.
Colorectal Dis
November 2024
Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.
Article Synopsis
- * Researchers reviewed 114 TPE cases but focused on 94 patients, comparing those who had primary suture closure with those who received p-ALT flap reconstruction.
- * Results indicated that the p-ALT flap group experienced significantly fewer severe pelvic abscesses and EPS-related readmissions compared to the primary closure group, suggesting it is a more effective reconstruction method.
Clinicopathologic features and surgical management in vulvovaginal melanoma - A retrospective single-center study.
J Plast Reconstr Aesthet Surg
October 2024
Department of Plastic Surgery, Helsinki University, Helsinki University Hospital, Helsinki, Finland.
Article Synopsis
- Vulvovaginal melanoma is a rare and aggressive form of cancer with low survival rates, reviewed in a study at Helsinki University Hospital over two decades.
- The majority of cases occurred in the vulva (86%), with surgery being the primary treatment method (86% of patients), but recurrences were common, particularly in distant sites.
- Key findings indicated that while wide local excision may be a viable treatment option, nodal status significantly impacts overall survival, highlighting the need for more research on lymph node evaluation in these patients.
Intraoperative Radiation Therapy for Recurrent Cervical and Endometrial Cancer: Predicting Morbidity and Mortality in a Contemporary Cohort.
Cancers (Basel)
October 2024
Department of Gynecologic Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.
Article Synopsis
- The study aimed to evaluate the effectiveness and safety of intraoperative radiation therapy (IORT) for treating recurrent cervical and endometrial cancer, along with identifying predictors of postoperative complications and mortality over three years.
- A total of 80 patients were analyzed, revealing a 3-year survival rate of 48.6%, with complications occurring in 20.1% of cases and one patient dying within 30 days post-surgery.
- Key risk factors linked to higher complications and mortality included poor performance status (ECOG PS 2-3), prior chemotherapy/immunotherapy, and the presence of pelvic sidewall involvement.
Patient Experiences of Long-term Pain and Pain Management Following Pelvic Exenteration for Locally Recurrent Rectal Cancer: A Qualitative Study.
Dis Colon Rectum
November 2024
Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District, Sydney, NSW, Australia.
Article Synopsis
- A study was conducted to explore patient experiences of chronic postoperative pain and its management after pelvic exenteration for locally recurrent rectal cancer, using one-on-one phone interviews with 17 patients.
- The main findings revealed three key themes: the need to adapt to long-term pain consequences, a reluctance to use pain medications, and the importance of a multidisciplinary care team for effective pain management.
- Limitations include a small sample size from a single center, making it difficult to generalize the results to all patients undergoing similar procedures.
Continuous infusion of piperacillin/tazobactam optimizes intraoperative antibiotic exposure in patients undergoing elective pelvic exenteration surgery.
Antimicrob Agents Chemother
December 2024
Faculty of Medicine, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Australia.
Article Synopsis
- Patients undergoing elective pelvic exenteration surgery are at risk of getting inadequate concentrations of the antibiotics piperacillin and tazobactam during surgery.
- This study aimed to analyze how these antibiotics are processed in the body (pharmacokinetics) and to find better dosing recommendations to ensure effective levels during surgery.
- Results showed that a lower continuous infusion dosage of piperacillin/tazobactam is effective in maintaining proper antibiotic levels, but patients with higher weights and kidney function might need higher doses to avoid suboptimal exposure.
Five-year quality-of-life assessment by urinary diversion type after pelvic Exenterations.
Gynecol Oncol
December 2024
Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; Department of OB/GYN, Weill Cornell Medical College, 400 E 67th St, New York, NY 10065, USA. Electronic address:
Article Synopsis
- The study aimed to assess how urinary diversion methods during pelvic exenteration affect the quality of life for patients with recurrent gynecologic cancers.
- A retrospective analysis was conducted using validated questionnaires to measure participants’ health and functioning, dividing them into two groups based on urinary diversion type: continent (CD) and noncontinent (NCD).
- Results showed improvements in overall health and physical functioning over time, with CD patients reporting better social functioning and body image, but both groups ultimately returned to their baseline quality of life within a year after surgery.
IMPACT organizational survey highlighting provision of services for patients with locally advanced and recurrent colorectal cancer across Great Britain and Ireland.
Colorectal Dis
December 2024
Improving Outcomes for Advanced Colorectal Tumours, Association of Coloproctologists of Great Britain and Ireland, London, UK.
Article Synopsis
- The study aims to understand how multidisciplinary teams (MDTs) in Great Britain and Ireland provide clinical services for patients with locally advanced and recurrent colorectal cancer, to support future service improvements.
- A survey with 12 questions was distributed to all colorectal cancer MDTs in GB&I, with a high response rate of 93.5%, encompassing 175 participating teams.
- Results showed significant variation in available services, including surgical options and specialized care, with only a minority of hospitals offering certain advanced surgical techniques and dedicated support for patients.
A Case of Oropharyngeal Carcinoma Accompanying a Presacral Malignant Epidermoid Cyst.
Cureus
September 2024
Plastic Surgery, Yodogawa Christian Hospital, Osaka, JPN.
Article Synopsis
- Presacral epidermoid cysts are uncommon benign tumors that can turn malignant; a case study reports a 66-year-old woman whose cyst transformed into squamous cell carcinoma (SCC) that spread to her mesopharynx.
- After the diagnosis, the patient underwent extensive surgery, including total pelvic exenteration, and received adjuvant radiotherapy, but developed a new mesopharyngeal carcinoma four years later.
- She was treated with neoadjuvant chemotherapy and surgery, ultimately showing no signs of tumor recurrence 1.5 years after her operations, highlighting the rarity of metastatic mesopharyngeal carcinoma from other sites.
Immunotherapy in the treatment of rectal invasion by prostate cancer with focal neuroendocrine differentiation: a case report and literature review.
Transl Androl Urol
September 2024
Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China.
Article Synopsis
- * A case study highlights a patient with rectal invasion by prostate cancer, who underwent total pelvic exenteration (TPE) and was found to have a high tumor mutation burden; the patient subsequently received combined androgen deprivation therapy (ADT) and immunotherapy.
- * After six years, the patient showed no signs of recurrence, suggesting that TPE coupled with immunotherapy could enhance survival prospects in similar cases, emphasizing the need for accurate diagnosis through interdisciplinary collaboration and advanced testing.
Risk factors for major complications following pelvic exenteration: A NSQIP study.
Eur J Surg Oncol
December 2024
Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Article Synopsis
- The study investigates predictors of postoperative complications in women undergoing pelvic exenteration surgery for gynecologic cancers, based on data from the National Surgical Quality Improvement Program registry from 2012 to 2022.
- Out of 794 pelvic exenterations analyzed, minor complications occurred in 72.5% of cases, while major complications affected 31.5%, with organ/space infections and sepsis being the most common severe issues.
- Key factors linked to higher risks of major complications include higher BMI, diabetes, low serum albumin levels, and elevated serum creatinine levels.
Intraoperative 'pressure field' haemodynamic monitoring in a patient with severe aortic regurgitation having laparoscopic robot-assisted colorectal surgery.
Anaesth Intensive Care
November 2024
Peter MacCallum Cancer Centre, Melbourne, Australia.
Article Synopsis
- - Laparoscopic robot-assisted colorectal surgery can be risky for patients with severe aortic regurgitation due to complications like increased pressure and blood flow issues that can lead to heart problems.
- - Transoesophageal echocardiography (TOE) helps manage these challenges during surgery but requires specialized skills and isn’t perfect for understanding how afterload affects the heart.
- - The article discusses a case where both innovative pressure field haemodynamic monitoring and TOE were successfully used together during a surgery, providing better real-time insights into the patient's heart function.
Post-traumatic reactions and quality of life after pelvic exenteration for gynecologic cancer: a retrospective cohort study.
Support Care Cancer
October 2024
Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Article Synopsis
- The study focused on the post-traumatic reactions and overall quality of life in women who underwent pelvic exenteration (PE) for recurrent gynecologic cancer.
- Out of 21 participants, 30% showed significant signs of post-traumatic stress and 71% had notable depressive symptoms, indicating mental health challenges post-surgery.
- Comparatively, these women's quality of life was lower than the general population but similar to those with advanced ovarian or cervical cancer, highlighting the need for ongoing support and rehabilitation in their recovery.