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April 1968

Multidiscipline Approach to Treatment of Recurrent Pelvic Neoplasms

Author Affiliations

Ann Arbor, Mich
From the Department of Surgery, Section of General Surgery; Department of Obstetrics and Gynecology; Gynecology Tumor Service; and Department of Surgery, Section of Urology, University of Michigan Medical Center, Ann Arbor.

Arch Surg. 1968;96(4):493-501. doi:10.1001/archsurg.1968.01330220009002

THE RADICAL surgical treatment of recurrent carcinoma of the cervix was first proposed by Brunschwig in 1948.1 With the accumulation of experience, operative morbidity and mortality has steadily decreased so that current rates are quite acceptable.2-4 Sufficient time has elapsed so that definitive five-year survival statistics have been accumulated,2-4 and these justify the continued utilization of pelvic exenteration for the treatment of recurrent carcinoma of the cervix and other pelvic malignancies. However, controversy or at least a certain amount of confusion exists regarding who should perform such surgery. It is immediately apparent that in removing the female reproductive organs, pelvic lymphatics, bladder, urethra, distal ureters, rectosigmoid, rectum and anus en bloc, and creating a sigmoid colostomy and a form of urinary diversion that one involves the separate disciplines of general surgery, gynecology, and urology. It is uncommon to-day for one surgeon to be competent enough in all