title: [Laparoscopic anterior pelvic exenteration in a patient with locally advanced melanoma].
abstract: BACKGROUND
  Pelvic exenteration is one of the most mutilating surgical procedures with high post-operative morbidity. The laparoscopic technique aims to reduce perioperative complications and reduce post-surgical recovery.
  
  
  OBJECTIVE
  We present the first case of laparoscopic anterior exenteration for locally advanced melanoma, held at the National Cancer Institute and published in Mexico.
  
  
  METHODS
  Patient 60 years of age diagnosed with invasive vulvar melanoma with bladder extension upon whom laparoscopic anterior pelvic exenteration with external urinary reconstruction was performed. Time in surgery was 505minutes and estimated blood loss was 400ml. No complications occurred during or immediately after surgery. The final histopathological study reported: nodular lesion that completely replaces the clitoris and spreads to the left labia majora, measures 3×2.5×2cm and is located relative to the free margins with perineural invasion intraepithelial spread in space and urethra and bladder trigone.
  
  
  CONCLUSIONS
  The laparoscopic anterior pelvic exenteration is a safe alternative in well-selected patients, with acceptable time in surgery, surgical complications and recovery time.
authors.affiliation: Servicio de Ginecología Oncológica, Instituto Nacional de Cancerología, Ciudad de México, México. Electronic address: islasurgery@hotmail.com.
authors.forename: David
authors.initials: D
authors.lastname: Isla-Ortiz
authors.affiliation: Servicio de Ginecología Oncológica, Instituto Nacional de Cancerología, Ciudad de México, México.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Montalvo-Esquivel
authors.affiliation: Servicio de Patología, Instituto Nacional de Cancerología, Ciudad de México, México.
authors.forename: Roberto Eduardo
authors.initials: RE
authors.lastname: Herrera-Goepfert
authors.affiliation: Servicio de Ginecología Oncológica, Instituto Nacional de Cancerología, Ciudad de México, México.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Herrera-Gómez
authors.affiliation: Servicio de Ginecología Oncológica, Instituto Nacional de Cancerología, Ciudad de México, México.
authors.forename: Rosa Angélica
authors.initials: RA
authors.lastname: Salcedo-Hernández
mesh_terms: D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000175:diagnosis; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis; D010385:Pelvic Exenteration / Q000379:methods*; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy; D001743:Urinary Bladder / Q000473:pathology; D014547:Urinary Diversion / Q000379:methods; D014594:Uterine Neoplasms / Q000175:diagnosis; D014846:Vulvar Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Anterior pelvic; Exenteración; Exenteration; Laparoscopia; Laparoscopy; Pélvica anterior