Critical evaluation of contemporary management in a new Pelvic Exenteration Unit: The first 25 consecutive cases

• 作者: Min Hoe Chew Yu-Ting Yeh Ee-Lin Toh Stephen Aditya Sumarli Ghee Kheng Chew Lui Shiong Lee Mann Hong Tan Tiffany Priyanthi Hennedige Shin Yi Ng Say Kiat Lee Tze Tec Chong Hairil Rizal Abdullah Terence Lin Hon Goh Mohamed Zulfikar Rasheed Kok Chai Tan Choong Leong Tang
• 来源期刊: 世界胃肠肿瘤学杂志：英文版（电子版）
• 学科: 医学
• 关键词: Colorectal 癌症 先进的骨盆的瘤 SACRECTOMY Oncological 结果 骨盆的取出肚肠 CHORDOMA
• 年，卷（期）: 2017,（5）
• 页码范围: 218-227
• 页数: 10页
• 分类号: R730.5

摘要

AIM To critically appraise short-term outcomes in patientstreated in a new Pelvic Exenteration(PE) Unit.METHODS This retrospective observational study was conducted by analysing prospectively collected data for the first 25 patients(16 males, 9 females) who underwent PE for advanced pelvic tumours in our PE Unit between January 2012 and October 2016. Data evaluated included age, co-morbidities, American Society of Anesthesiologists(ASA) score, Eastern Cooperative Oncology Group(ECOG) status, preoperative adjuvant treatment, intra-operative blood loss, procedural duration, perioperative adverse event, lengths of intensive care unit(ICU) stay and hospital stay, and oncological outcome. Quantitative data were summarized as percentage or median and range, and statistically assessed by the χ~2 test or Fisher’s exact test, as applicable.RESULTS All 25 patients received comprehensive preoperative assessment via our dedicated multidisciplinary team approach. Long-course neoadjuvant chemoradiotherapy was provided, if indicated. The median age of the patients was 61.9-year-old. The median ASA and ECOG scores were 2 and 0, respectively. The indications for PE were local y invasive rectal adenocarcinoma(n = 13), advanced colonic adenocarcinoma(n = 5), recurrent cervical carcinoma(n = 3) and malignant sacral chordoma(n = 3). The procedures comprised 10 total PEs, 4 anterior PEs, 7 posterior PEs and 4 isolated lateral PEs. The median follow-up period was 17.6 mo. The median operative time was 11.5 h. The median volume of blood loss was 3306 mL, and the median volume of red cell transfusion was 1475 mL. The median lengths of ICU stay and of hospital stay were 1 d and 21 d, respectively. There was no case of mortality related to surgery. There were a total of 20 surgical morbidities, which occurred in 12 patients. The majority of the complications were grade 2 Clavien-Dindo. Only 2 patients experienced grade 3 Clavien-Dindo complications, and both required procedural interventions. One patient experienced grade 4a Clavien-Din