Comparison of immediate surgical outcomes between posterior pelvic exenteration and standard resection for primary rectal cancer: a matched case-control study.
OBJECTIVE
To determine the immediate surgical outcome and recovery of bowel function following posterior pelvic exenteration (PPE) for primary rectal cancer with suspected local invasion to the female internal reproductive organs, in comparison with a case-control series of standard resection for primary rectal cancer.


METHODS
We analyzed 10 consecutive female patients undergoing PPE for the aforementioned indication between December 2003 and May 2006 in a single institution. Data were prospectively collected during hospitalization, including patient demographics, tumor- and operation-related variables and early surgical outcomes. These patients were compared with a group of female patients, matched for age, co-morbidity and location of tumor, who underwent standard resection for primary rectal cancer in the same period (non PPE group).


RESULTS
In the PPE group, pathological reports showed direct invasion of the reproductive organs in 4 cases and an involvement of lymph nodes in 7 cases. A sphincter-saving operation was performed in each case. Operative time was longer (274 min vs 157 min, P < 0.001) and blood loss was greater (769 mL vs 203 mL, P = 0.008) in the PPE group. Time to first bowel movement, time to first defecation, time to resumption of normal diet, and hospital stay were not significantly different between the two groups. Postoperative complication rates were also similar.


CONCLUSIONS
PPE for rectal cancer was associated with longer operative time and increased blood loss, but did not compromise immediate surgical outcomes and postoperative bowel function compared to standard rectal resection.
Lohsiriwat
Varut
V
Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Prannok Rd, Bangkoknoi, Bangkok 10700, Thailand. bolloon@hotmail.com
Lohsiriwat
Darin
D
D000230:Adenocarcinoma / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D016022:Case-Control Studies; D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D004435:Eating; D005260:Female; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010385:Pelvic Exenteration / Q000009:adverse effects; D011446:Prospective Studies; D020127:Recovery of Function; D012004:Rectal Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome