title: Laparoscopy-assisted vaginal pelvic exenteration.
abstract: OBJECTIVE
  The aim of this study was to evaluate the feasibility, morbidity and survival outcome of laparoscopy-assisted vaginal pelvic exenteration.
  
  
  METHODS
  Since 2000, we have performed 5 cases of en-bloc pelvic exenteration combining a vaginal or perineal approach and laparoscopic approach. All patients had received previous pelvic irradiation. One patient underwent a total type II exenteration with ileal-loop diversion, an omental flap and a temporary colostomy. Two patients underwent a middle and posterior exenteration: one was a type III exenteration with perineal rectal resection and a gracilis myocutaneous flap; the second one was a type II exenteration with a colorectal anastomosis and a vaginal reconstruction using a gluteal thigh flap. Two patients underwent a type I anterior and middle exenteration with continent Miami pouch and vaginal reconstruction by omental cylinder.
  
  
  RESULTS
  Mean time of the procedure was 6 h (range: 4.5-9). Peroperative bleeding was less than 500 cm3. Two patients presented minor complications: a perineal abscess after perineal rectal resection and an abdominal wound abscess. Mean length of hospital stay was 27 days. Three patients are free of disease. Two patients presented groin metastasis. One patient died of disease after 8 months.
  
  
  CONCLUSIONS
  Laparoscopic or laparoscopy-assisted vaginal pelvic exenteration followed by reconstruction is feasible with curative intent in selected patients.
authors.affiliation: Department of Surgical Oncology, Institut Claudius Regaud Cancer Center, 20-24, rue du Pont St Pierre, 31052 Toulouse Cedex, France. ferron@icr.fnclcc.fr
authors.forename: Gwénaël
authors.initials: G
authors.lastname: Ferron
authors.forename: Denis
authors.initials: D
authors.lastname: Querleu
authors.forename: Pierre
authors.initials: P
authors.lastname: Martel
authors.forename: Benoit
authors.initials: B
authors.lastname: Letourneur
authors.forename: Michel
authors.initials: M
authors.lastname: Soulié
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D010385:Pelvic Exenteration / Q000009:adverse effects / Q000379:methods*; D013524:Surgical Flaps