The First Pelvic Exenteration in West Sumatera : A Case Report
(1) Prodi Program Pendidikan Dokter Spesialis Obstetri dan Ginekologi Fakultas Kedokteran Universitas Andalas RSUP Dr. M. Djamil Padang
(2) Sub Division of Gynecological Oncology, Obstetrics and Gynecology Department, Faculty of Medicine, Andalas University, Dr. M. Djamil Central General Hospital Padang, West Sumatera, Indonesia
(*) Corresponding Author
DOI: https://doi.org/10.25077/aoj.6.1.82-88.2022
Abstract
Introduction: Pelvic exenteration (PE) is an ultra-radical surgical procedure introduced by Alexander Brunschwig in 1948, which a way for symptomatic palliative care in subjects with advanced gynecological malignancies that do not respond to radiation therapy, who experience subsequent complications including fistula, infection, or pain.
Objective: The aim of this case report is to share our first experience of pelvic exenteration in patient with recurrent cervical cancer in West Sumatera.
Case Report: We report the case of a 42-year-old woman, who was diagnosed with a progressive recurrent cervical cancer that had been treated with a radiotheraphy for cervical cancer stage IIIB and adjuvant chemotherapy. The patient was planned for pelvic exenteration. Prior to surgery, patient had done several preparations such as ultrasound, CT scan, laboratory tests, urologist and colorectal surgeon consult. The patient had undergone a supralevator pelvic exenteration by gynecologic oncologist, urologist and colorectal surgeon. The supralevator exenteration pelvic included total hysterectomy, bilateral salpingo-oophorectomy, cystectomy, and Miles procedure. The reconstruction process included ileal conduit and colostomy.
Conclusions: Pelvic exenteration can be done with good teamwork between gynecologic oncologist, urologist, colorectal surgeon with postoperative complications (hypoalbuminemia and low intake) can be tolerated.
Keywords: supralevator pelvic exenteration, cervical cancer
Full Text:
PDFReferences
Düzgüner S, Zengin T, Taşçı T, Turan T, Boran N, Tulunay G, Köse M. Long-term survival after total pelvic exenteration in a patient with recurrent cervical carcinoma: A case report. 2013, 186-188
Marnitz S, Köhler C, Müller M, Behrens K, Hasenbein K, Schneider A. Indications for primary and secondary exenterations in patients with cervical cancer. Gynecol Oncol. 2016, 103:1023-30.
Bacalbasa N, Balescu I, Tomescu D, Barosveanu V. Total pelvic exenteration for locally invasive cervical tumor in an elderly patient - a case report and literature review. J. Transl. Med. Res. 2015, 1(20):38-41.
Maharaj R, Sookdeoa D,Fortuné M, Akhileshc M, et al. Pelvic exenteration case series: A single surgeon’s experience at one institution in Trinidad and Tobago. Elsevier: International Journal of Surgery Case Report 34. 2017, 4-10.
R. Maharaj et al. Pelvic exenteration case series: A single surgeon’s experience at one institution in Trinidad and Tobago. International Journal of Surgery Case Reports 34. 2017, 4–10.
Kaur M, Joniau S, D’Hoore A, Vergote I. Indications, techniques and outcomes for pelvic exenteration in gynecological malignancy. Lippincot William. 2014. Vol.6
Sardain H, Lavoue V, Redpath M, Bertheui N, Foucher F, Leveque J. Curative pelvic exenteration for recurrent cervical carcinoma in the era of concurrent chemotherapy and radiation therapy. A systematic review. EJSO - European Journal of Surgical Oncology, WB Saunders. 2015, 41 (8), pp.975-985.
Kaur M, Joniau S, D’Hoore A, Vergote I. Indications, techniques and outcomes for pelvic exenteration in gynecological malignancy. Curr Opin Oncol. 2014, 26(5):514–520.
Fleisch C, Rein D and Janni W. The place of pelvic exenteration as a cytoreductive procedure in advanced gynaecologic malignancies. Department of Obstetrics and Gynaecology, Heinrich-Heine-University, Düsseldorf. Cytoreductive Surgery in Gynecologic Oncology: A Multidisciplinary Approach. 2010, 179-200
Kim J. Pelvic Exenteration: Surgical Approach. Journal of Korean Society Coloprotology. Division of Colorectal Surgery, Department of Surgery, Korea University College of Medicine, Seoul, Korea. 2012, 286-293.
Jalloul RJ, Nick AM, Munsell MF, Westin SN, Ramirez PT, Frumovitz M, Soliman PT. The influence of surgeon volume on outcomes after pelvic exenteration for a gynecologic cancer. J Gynecol Oncol. 2018, 29:e68.
Ter Glane L, Hegele A, Wagner U, Boekhoff J. Pelvic exenteration for recurrent or advanced gynecologic malignancies – Analysis of outcome and complications. Gynecologic Oncology Reports 36. 2021. 100757.
Petruzziello et al. Surgical results of pelvic exenteration in the treatment of gynecologic cancer. World Journal of Surgical Oncology 2014, 12:279.
Lewandowska A, Szubert S, Koper K, Koper A, Cwynar G, Whicerek L. Analysis of long-term outcomes in 44 patients following pelvic exenteration due to cervical cancer. World Journal of Surgical Oncology. 2020, 18:234.
Bacalbasa N, Balescu, Vilcu M, Dima S, Brezean I. The Impact of the Preoperative Status on the Short-term Outcomes After Exenteration and Pelvic Reconstruction. In Vivo. 2019, 33(6), 2147–2152.
Diver E, Rauh-Hain J, del Carmen M. Total Pelvic Exenteration for Gynecologic Malignancies. International Journal of Surgical Oncology. 2012;2012:1-9.
Lampe B, Luengas-Würzinger V, Weitz J, Roth S, Rawert F, Schuler E et al. Opportunities and Limitations of Pelvic Exenteration Surgery. Cancers. 2021;13(24):6162.
Unal E. Complications of Pelvic Exenteration Encountered by both Surgical Oncologists and Anesthesiologists. Anaesthesia & Critical Care Medicine Journal. 2019;4(3).
Aslim E, Chew M, Chew G, Lee L. Urological outcomes following pelvic exenteration for advanced pelvic cancer are not inferior to those following radical cystectomy. ANZ Journal of Surgery. 2018;88(9):896-900.
Brown K, Solomon M, Koh C. Pelvic Exenteration Surgery: The Evolution of Radical Surgical Techniques for Advanced and Recurrent Pelvic Malignancy. Diseases of the Colon & Rectum. 2017;60(7):745-754.
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Address for Correspondence: