title: Locally recurrent rectal cancer successfully treated by total pelvic exenteration with combined ischiopubic rami resection: report of a case.
abstract: A combined ischiopubic rami resection is extremely rare in the field of gastroenterologic surgery. We report a case of a locally recurrent rectal cancer that was successfully treated by total pelvic exenteration with combined ischiopubic rami resection. A 58-year-old male with locally recurrent rectal cancer and liver metastases was referred to our hospital. Computed tomography and magnetic resonance imaging showed a perineal tumor, which had invaded the prostate, urethra, and obturator internus muscle, and two liver metastases. Because the perineal tumor was very close to the dorsal vein complex and the pubic symphysis, it was considered difficult to approach and divide the dorsal vein complex, and still retain oncologic safety. To achieve R0 resection, total pelvic exenteration with ischiopubic rami resection, total emasculation and partial liver resection were performed. Pathological examination revealed that surgical margins were negative for cancer cells. Although reconstruction of the pelvic ring was not performed, his ambulatory function had recovered to an almost normal status at 6 months after the operation.
authors: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Nagoya 466-8550, Japan. kuehara@med.nagoya-u.ac.jp
authors: Keisuke
authors: K
authors: Uehara
authors: Yuichiro
authors: Y
authors: Yoshioka
authors: Yoshiro
authors: Y
authors: Taguchi
authors: Tsuyoshi
authors: T
authors: Igami
authors: Tomoki
authors: T
authors: Ebata
authors: Yukihiro
authors: Y
authors: Yokoyama
authors: Gen
authors: G
authors: Sugawara
authors: Satoshi
authors: S
authors: Tsukushi
authors: Yoshihiro
authors: Y
authors: Nishida
authors: Yasushi
authors: Y
authors: Yoshino
authors: Masato
authors: M
authors: Nagino
mesh_terms: D006801:Humans; D007512:Ischium / Q000601:surgery*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery*; D010385:Pelvic Exenteration; D011630:Pubic Bone / Q000601:surgery*; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed