title: Radical vulvectomy with partial rectal resection and temporary colostomy as primary therapy for selected patients with vulvar carcinoma.
abstract: The patient with carcinoma of the vulva may present with tumor involvement of the perirectal area. Traditional treatment has often involved ultraradical therapy including a radical vulvectomy with posterior or total pelvic exenteration in an effort to obtain adequate surgical margins. Five-year survival rates for these patients range from 20-50%, and major operative morbidity as well as psychological problems are associated with this extensive surgery. Five patients treated for a locally advanced vulvar carcinoma involving the perirectal area were thought to be candidates for a rectum-sparing procedure. They underwent a radical vulvectomy, bilateral inguinal lymphadenectomy, partial rectal resection, and a diverting colostomy. Four of the five patients agreed to a colostomy closure 6 months after their primary therapy; these four patients have resumed normal bowel function. All patients remain clinically free of tumor.
authors.affiliation: Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors.forename: S
authors.initials: S
authors.lastname: Remmenga
authors.forename: D
authors.initials: D
authors.lastname: Barnhill
authors.forename: J
authors.initials: J
authors.lastname: Nash
authors.forename: J
authors.initials: J
authors.lastname: Bosscher
authors.forename: M
authors.initials: M
authors.lastname: Teneriello
authors.forename: R
authors.initials: R
authors.lastname: Park
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D003125:Colostomy / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D012007:Rectum / Q000601:surgery*; D014844:Vulva / Q000601:surgery*; D014846:Vulvar Neoplasms / Q000601:surgery*