LAPAROSCOPIC PELVIC EXENTERATION: A PILOT STUDY

V.K. Lyadov1-3, A.N. Moskalenko1, M.R. Garipov1, A.A. Bogdanov4, A.S. Nevrov5, V.N. Galkin1

1City Clinical Oncological Hospital №1, Moscow

2Novokuznetsk State Institute for Postgraduate Medical Education ― Branch Campus of the FSBEI FPE RMACPE MOH Russia, Novokuznetsk

3Russian Medical Academy of Continuous Professional Education, Moscow

4Hadassah Medical Moscow, Moscow

5N.I. Pirogov Russian National Research Medical University, Moscow

Lyadov Vladimir K. ― Doct. of Sci. (Med.), Professor, Head of the Department of Oncology №4 of the City Clinical Oncological Hospital №1; Head of the Department of Oncology of the Novokuznetsk State Institute for Postgraduate Medical Education ― Branch Campus of the FSBEI FPE RMACPE MOH Russia; Professor of the Department of Oncology and Palliative Medicine named after akad. A.I. Savitsky of Russian Medical Academy of Continuous Professional Education

18A Zagorodnoe highway, Moscow, 117152, Russian Federation, tel. +7-916-195-68-27, e-mail: vlyadov@gmail.com, ORCID ID: 0000-0002-7281-3591

Abstract. Pelvic exenteration is indicated in patients with locally advanced pelvic tumors, including cancer of the rectum, cervical carcinoma, ovarian cancer and other localizations. Mini-invasive approach is an accepted way of prevention of surgical complications, especially in this «high risk» surgery. We report an analysis of 18 laparoscopic pelvic exenterations including 10 posterior, 4 anterior and 4 total procedures. Indications were cancer of the rectum in 10 patients, anal carcinoma in 1 case and gynecological malignancies in 7 other patients. Pelvic irradiation of the small pelvis was in the history of 11 patients, 9 tumors were recurrent. The average duration of operations was 411±137 (210-640) minutes, the average volume of blood loss was 192±133 (50-500) ml. Hospital and 90-day mortality after surgery was not observed. A complication that required surgery occurred only in 1 patient: bleeding from a flap of the rectus abdominis muscle transferred to the small pelvis. The median postoperative day was 13,5±12,5 (6-53) days. We consider it necessary to further study the results of laparoscopic exenterations in order to reduce of complications in surgery for locally advanced tumors of the pelvic.

Key words: laparoscopy, pelvic exenteration, rectal cancer, cervical cancer, endometrial cancer.