Survival rate and complications after different types of pelvic exenteration for gynecological cancer

Pelvic exenteration (PE) is an operative method for one-moment removal of pelvic organs, including reproductive tract, bladder, and rectosidgmoid. It is most commonly indicated in gynecologic oncology for treatment of locally advanced cancer or recurrence with central localization. The purpose of this study was to evaluate survival rate and complications in different types of PEs performed for cervical, uterine, and ovarian cancer and to report the authors’ experience. Patients undergoing PE for cervical, uterine, and ovarian cancer (n=46) were prospectively collected. Operative techniques types included total PE (n=9), anterior PE (n=14), posterior PE (n=7), and modified posterior PE (n=16). Overall intra and postoperative complication rate was 34.8% for the series. Mild complications occurred in 28.2% and severe complications in 6.5%. Perioperative mortality was 2.2%. PE in patients with advanced stage of gynecological malignancies was associated with high complication rate and high perioperative mortality and morbidity. Therefore, operative techniques with proven safety should be used. Creating ureter anastomosis with incontinent urinary conduit from terminal ileum can be considered as such technique. Although all factors that impact negative on quality of life, PE remains an alternative for extending life of these types of patients.

Pelvic exenteration; Cervical cancer; Ovarian cancer; Endometrial cancer; Complications

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