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Type: Journal article
Title: Short- and long-term outcomes of selective pelvic exenteration surgery in a low-volume specialized tertiary setting
Author: Humphries, E.L.
Kroon, H.M.
Dudi Venkata, N.
Thomas, M.L.
Moore, J.W.
Sammour, T.
Citation: ANZ Journal of Surgery, 2019; 89(6):E226-E230
Publisher: WILEY
Issue Date: 2019
ISSN: 1445-2197
Statement of
Emily L. Humphries, Hidde M. Kroon, Nagendra N. Dudi-Venkata, Michelle L. Thomas, James W. Moore and Tarik Sammour
Abstract: BACKGROUND: Most published data on pelvic exenteration comes from high-volume quaternary units, with limited data available from outside of this setting. This study reports outcomes of selective pelvic exenteration performed in a low-volume tertiary unit with multidisciplinary support. METHODS: A retrospective review of consecutive patients who underwent pelvic exenteration surgery for rectal/anal carcinoma, or gynaecological malignancy at Royal Adelaide Hospital between June 2008 and September 2018. Descriptive statistics and Kaplan-Meier analysis of 5-year disease-free and overall survival for patients treated with curative intent were performed. RESULTS: A total of 54 patients who underwent pelvic exenteration were included. Most patients presented with primary rectal adenocarcinoma, and posterior and total pelvic exenterations were the most common operations performed (>90%). Median total operating time was 323 min, median hospital stay was 15 days, and the readmission rate was 14.8%. The overall complication rate (per patient) was 70.4%, and the re-intervention rate was 20.4%. Thirteen percent of patients required intensive care unit-admission, and there was one postoperative death (1.9%). R0 resection margins were achieved in 81.5% of patients, with R1 and R2 margins in 13.0 and 5.6% of patients, respectively. Estimated 5-year disease-free survival was 38.8%, and 5-year overall survival was 65.7%. CONCLUSION: Short- and long-term outcomes of selective pelvic exenteration surgery are acceptable in a low-volume specialized tertiary setting with suitable multidisciplinary expertise. If the required expertise is not readily available, then outside referral is recommended.
Keywords: colorectal pelvic exenteration
Rights: © 2019 Royal Australasian College of Surgeons
DOI: 10.1111/ans.15212
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