Álvarez-Fernández D, Deras-Cabral S, Guerrero-Romero F

Language: Spanish
References: 21
Page: 221-225
PDF size: 73.18 Kb.

ABSTRACT

Introduction: The treatment of the advanced cell carcinoma of the cervix currently is limited. The radical hysterectomy with pelvic exenteration has both high morbidity and mortality. Objective: To describe the outcome of patients with advanced or recurrent pelvic carcinoma treated with a novel chirurgical technique of pelvic exenteration preceded by regional ischemia. Material and method: We present the results of the pelvic exenteration achieved in two times. In the first time, lymph and paraaortic nodes and suspicious tumoral areas of both abdominal and retroperitoneal cavities are biopsed and immediately evaluated. If the histological evaluation showed not the presence of malignant cells, a Bricker’s duct or cecal bladder as well as a colostomy are performed. The mesenteric artery and both hypogastric arteries are clamped. In the second time, after seven days a pelvic exenteration is carried out, removing in block the necrotic pelvic contain. Results: Three women aged 51.7 ± 10 years, clinically out of oncologic treatment by transitional cells bladder carcinoma, cervical adenocarcinoma II B, and large cell keratinizing epidermoid cervical carcinoma, gave its informed consent to be treated with pelvic exenteration preceded by regional ischemia. The average chirurgical bleeding were of 700 mL (500 to 1,000 mL), with minimal morbidity. Two women are alive without tumoral activity, and an average survival of 24.3 (1-60) months. Discussion: The pelvic exenteration preceded by regional ischemia improve the tumoral resection, reducing the morbidity and mortality so, it could be an alternative for treating advanced pelvic carcinoma.

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