total pelvic exenteration for gynecologic malignancies总盆腔清除术妇科恶性肿瘤.pdfVIP

Hindawi Publishing Corporation International Journal of Surgical Oncology Volume 2012, Article ID 693535, 9 pages doi:10.1155/2012/693535 Review Article Total Pelvic Exenteration for Gynecologic Malignancies Elisabeth J. Diver, J. Alejandro Rauh-Hain, and Marcela G. del Carmen Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Yawkey 9E Boston, MA 02114, USA Correspondence should be addressed to Marcela G. del Carmen, mdelcarmen@ Received 24 February 2012; Accepted 10 April 2012 Academic Editor: Constantine P. Karakousis Copyright © 2012 Elisabeth J. Diver et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Total pelvic exenteration (PE) is a radical operation, involving en bloc resection of pelvic organs, including reproductive structures, bladder, and rectosigmoid. In gynecologic oncology, it is most commonly indicated for the treatment of advanced primary or locally recurrent cancer. Careful patient selection and counseling are of paramount importance when considering someone for PE. Part of the evaluation process includes comprehensive assessment to exclude unresectable or metastatic disease. PE can be curative for carefully selected patients with gynecologic cancers. Major complications can be seen in as many as 50% of patients undergoing PE, underscoring the need to carefully discuss risks and benefits of this procedure with patients considering exenterative surgery. 1. Introduction focus of the surgery shifted to one of curative intent. Various