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November 1985

Complications of Pelvic Exenteration

Author Affiliations

From the Departments of General Oncologic Surgery (Drs Jakowatz, Porudominsky, Riihimaki, Kemeny, Kokal, Terz, and Beatty) and Gynecologic Oncology (Dr Braly), City of Hope National Medical Center, Duarte, Calif.

Arch Surg. 1985;120(11):1261-1265. doi:10.1001/archsurg.1985.01390350043009

• 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)