Pelvic exenteration case series: A single surgeon's experience at one institution in Trinidad and Tobago.
BACKGROUND
Pelvic exenteration (PE) is an ultra-radical surgical procedure characterized by the en bloc resection of the pelvic organs.


METHODS
In this case series, we report retrospectively on four patients who underwent PE in Trinidad and Tobago from 2012 to 2016. One male patient had rectal cancer while one each of three women had cervical, colon, or rectal cancer.


RESULTS
Early postoperative complications (≤30days) occurred in all patients, while late complications (>30days) occurred in one patient (Grade 1 - Clavien-Dindo classification). Disease recurrence occurred in 50% of patients, and the median overall survival was 8 months (range, 4-15 months).


CONCLUSIONS
There are many inherent challenges to conducting such major procedures in developing countries, including inadequate blood product supplies, intensive care unit beds, and pre- and post-operative support services. With increased surgical capacity and support infrastructure, hospitals in these regions would be equipped to perform PEs with better outcomes.


CONCLUSIONS
This case series adds to existing data on the feasibility of performing PE in developing countries. We demonstrate that PE can be performed without major postoperative complications in a resource-limited hospital. To the best of our knowledge, this is the first case series that describes PE in the Caribbean.
Department of Clinical Surgical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago. Electronic address: drravimaharajuwi@gmail.com.
Ravi
R
Maharaj
Department of Clinical Surgical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago. Electronic address: vandanahealth@gmail.com.
Vandana Devika
VD
Sookdeo
Department of Radiology, University of the West Indies, Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago. Electronic address: mfortune333@hotmail.com.
Maurice
M
Fortuné
Department of Paraclinical Science, University of the West Indies, Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago. Electronic address: meenakshi_akhilesh@hotmail.com.
Meenakshi
M
Akhilesh
Department of Paraclinical Science, University of the West Indies, Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago. Electronic address: avcraouwi@gmail.com.
Chalapathi Rao Adidam
CRA
Venkata
Department of Paraclinical Science, University of the West Indies, Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago. Electronic address: wayne.mohammed@sta.uwi.edu.
Wayne
W
Mohammed
Department of Clinical Surgical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago. Electronic address: dave_harnanan@yahoo.com.
Dave
D
Harnanan
Division of Oncology, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO 63110, USA. Electronic address: wayne.warner@wustl.edu.
Wayne A
WA
Warner
Cancer; Case series; Pelvic exenteration; Retrospective single institution review; Trinidad and Tobago