Pelvic Exenteration for Locally Advanced Carcinoma Located in Sigmoid Colon and Rectum

Jung, Byung Ok; Kim, Hyeong Rok; Kim, Dong Yi; Kim, Young Jin

Abstract

PURPOSE
Extensive local growth of rectal carcinoma and sigmoid colon carcinoma without evidence of extrapelvic dissemination occurs infrequently but does represent a small number of potentially curable neoplasms. Such lesions may present with bulk-related problems such as pelvic pain and lower colonic obstruction or with rectum, the vagina, or the bladder. Even in the absence of distant spread, many of these patients will have unresectable disease and will undergo an incomplete resection or proximal colostomy for pallliation. In selected patients, some of the locally advanced rectal cancer may be curable if total pelvic exenteration is performed.
METHODS
This report describe a group of patients with locally advanced sigmoid or rectal carcinoma confined to the pelvis who underwent total pelvic exenteration at the Chonnam University Hospital.
RESULTS
Seven patients had received total pelvic exenteration within five years and they were all men. One patient among them had recurred rectal cancer after previous abdominoperineal resection. Four rectal cancer and three sigmoid colon cancer were included and the range of age was third to eighth decade. According to modified Dukes' stage, stage B3 were five, and C2 were two. Postoperative complications were presented in three patients. They were wound infection, mechanical ileus, and anastomotic leakage.
CONCLUSIONS
Postoperative death was presented in one patient due to sepsis with mechanical ileus. Long term follow up of these patients which was arranged from two to fourty-seven months showed five patients alive and one patient died.