MULTIVISCERAL RESECTION AND TOTAL PELVIC EVISCERATION FOR LOCALLY ADVANCED RECTAL CANCER

E.V. Kalinin1, O.M. Rossomakhina2

1Republican Oncologic Dispensary, Grozny

2Lugansk State Medical University, Lugansk

Kalinin E.V. ― Cand. Med. Sc., Associate Professor, Head of the Surgical Department at Grozny Republican Onclogic Dispensary

3 Okruzhnoy-15 Grozny, Russian Federation, 364029, tel. +7-989-922-74-92, e-mail: kalinin.egn@mail.ru

Abstract

The aim ― to analyze the postoperative and long-term results (5-10 year survival) after multivisceral resections and evisceration of the pelvic organs in patients with locally advanced rectal cancer.

Material and methods. 252 patients with locally advanced rectal cancer were analized. In the research group of patients (n=178) we performed multivisceral resection of pelvic organs Control group consisted of 74 patients (29.36%) with total evisceration of pelvic organs. All patients underwent R0 resection.

Results. Postoperative complications were observed in 92 patients (36.5%). Complications degree I-II ― 57 patients (61.95%); complications of III-IV degree ― 35 patients (13.88%). Mortality ― 7.6%. In the research group, postoperative complications were diagnosed in 48 of patients (52.17%), including complications of grade 3 ― in 19 (7.54%), grade 4 ― in 3 patients (1.19%). Mortality ― 1.98. In the control group, complications were found in 44 patients (47.83%), including complications of grade 3 ― 8 (3.17%), grade 4 ― 5 (1.98%). Mortality rate ― 0.79%.

All patients was performed R0 multivisceral resection or pelvic evisceration with resection and prosthetic great vessels, plastic and reconstruction of the removed organs. 5-year survival overall (in the two groups) was 52.05%. 5-year survival rate of patients with the third stage of the disease ― 38.3%.

Conclusion. Implementing the principles of oncological radicalism allows to achieve satisfactory immediate and long-term results of surgical treatment of patients with locally advanced rectal cancer.

Key words: multivisceral resection, locally advanced rectal cancer, pelvic evisceration, cytoreductive surgery (R0-2).