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Revista chilena de cirugía

versión On-line ISSN 0718-4026

Resumen

BANNURA, Guillermo et al. Total pelvic exenteration for locally advanced rectal tumors: Experience in 10 patients. Rev Chil Cir [online]. 2016, vol.68, n.3, pp.237-244. ISSN 0718-4026.  http://dx.doi.org/10.1016/j.rchic.2015.10.002.

Aim: To report the results of total pelvic exenteration (TPE) in patients with locally advanced primary rectal tumors. Material and method: We report 10 patients with stage 4 rectal tumors subjected to a potentially curative TPE in a period of 16 years. Results: Six patients received also adjuvant chemoradiotherapy. A classic technique was used in 3 patients and a supra-elevator technique in 6. Mean hospitalization length was 36 days, and 80% of patients had complications. The pathological study of the surgical piece confirmed a T4 tumor in 6 patients, T3 in 3 and T0 in one. Among patients who received chemoradiotherapy, one was in stage ypT0N0M0, 2 in ypIIA, 2 in ypIIC, one in ypIIIB, 2 in pIIC and 2 in pIIIC. During follow up 3 patients survived between 30 and 180 months and three died due to distant metastases without local relapse. Conclusion: TPE requires long hospital stays and has a high rate of complications. Supra-elevator TPE protected with a transitory ileostomy avoided definitive colostomy in 6 of 10 cases. Urinary ileostomy had satisfactory long term functional results. The prolonged survival of half of the patients justifies the use of this surgical technique.

Palabras clave : Total pelvic exenteration; Rectal cancer; Chemoradiation.

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