Pelvic exenteration in modern gynecologic oncology – own experiences

Justyna Kot, Joanna Spaczyńska, Magdalena Duda-Wiewiórka, Michał Mleko, I. Ludwin, Kazimierz Pityński
In: Current Gynecologic Oncology · 2018 · vol. 16(4) , pp. 216–223 · doi:10.15557/cgo.2018.0025 · W2917754860
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⚙ AI-generated summary by claude@2026-06, 2026-06-11 ⓘ

This study analyzed indications and complications of pelvic exenteration in 8 gynecologic oncology patients over 5 years, finding high rates of early and late complications despite no early postoperative deaths.

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This single-center retrospective case series analyzed medical records of female patients undergoing pelvic exenteration between 2014 and 2018, excluding exenteration for ovarian cancer, to assess indications and intra- and postoperative complications. Eight procedures were performed, half intended as curative and half palliative, with recurrence of vulvar cancer accounting for half of the cases; the study also recorded operative duration, hospital stay, surgical margins, and complications graded by the Clavien–Dindo classification. Early postoperative complications occurred in every case, and severe complications (grades IIIb–V) were seen in 62.5%, with no early postoperative deaths, while late complications occurred in 75% and one death was reported 11 months after palliative exenteration. The authors’ main limitation is the very small number of cases and the retrospective, single-center design, which constrains generalizability. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Cel pracy: Analiza wskazań do zabiegu wytrzewienia oraz powikłań śród- i pooperacyjnych, na podstawie przypadków z jednego ośrodka ginekologii onkologicznej w ostatnich 5 latach. Materiał i metody: Szczegółowy przegląd dokumentacji medycznej pacjentek, u których wykonano zabieg wytrzewienia miednicy mniejszej w ciągu ostatnich 5 lat (od roku 2014 do 2018). W przeglądzie nie uwzględniono wytrzewień z powodu raka jajnika. Analizie poddano wskazania do zabiegu, wiek operowanych, lokalizację i typ histologiczny guza, przebyte wcześniej leczenie, stan sprawności i współchorobowość, cel i rodzaj zabiegu, czas trwania zabiegu, powikłania wczesne i późne wg klasyfikacji Claviena–Dindo, sposób odprowadzenia moczu, osiągnięte marginesy operacyjne. Wyniki: W okresie od początku 2014 do pierwszej połowy 2018 roku wykonano 8 zabiegów wytrzewienia miednicy mniejszej – 5 z intencją wyleczenia, 3 paliatywnie. Połowę chorych stanowiły przypadki wznowy raka sromu. Średni czas trwania zabiegu wyniósł 315 minut, średni czas pobytu w oddziale – 24,38 dnia. Wczesne powikłania pooperacyjne o różnym stopniu ciężkości wystąpiły w każdym operowanym przypadku, w tym powikłania ciężkie (IIIb–V wg Claviena–Dindo) u 5 kobiet (62,5%). Nie odnotowano zgonu we wczesnym okresie pooperacyjnym. Powikłania późne zaobserwowano łącznie u 6 pacjentek (75,0%), w tym jeden zgon 11 miesięcy po egzenteracji paliatywnej. Wnioski: Zabieg wytrzewienia miednicy mniejszej pomimo postępu w opiece okołooperacyjnej łączy się z wysokim ryzykiem powikłań, często zagrażających życiu. Każdy przypadek kwalifikujący się do tak radykalnego zabiegu operacyjnego należy traktować indywidualnie, a sama procedura powinna zostać przeprowadzona w ośrodku dysponującym odpowiednią kadrą i sprzętem medycznym.
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Pelvic exenteration in modern gynecologic oncology – own experiences Aim: Analysis of indications for the procedure of exenteration, and intra- and postoperative complications, based on cases from a single gynecologic oncology center over the past 5 years. Material and methods: Detailed review of medical records of female patients who underwent pelvic exenteration surgery over the last 5 years (2014–2018). The review excluded cases of exenteration for ovarian cancer. The analysis included indications for the procedure, age of operated patients, location and histological type of tumor, prior treatment history, performance status and comorbidities, purpose and type of procedure, duration of operation, early and late complications according to the Clavien–Dindo classification, method of urinary diversion, and achieved surgical margins. Results: A total of 8 pelvic exenteration procedures were performed between early 2014 and mid-2018, including 5 procedures with the intention to cure, and 3 palliative procedures. Half of the cases involved patients with recurrence of vulvar cancer. The mean duration of the procedure was 315 minutes, while the mean duration of stay in the hospital ward was 24.38 days. Early postoperative complications of varying severity occurred in each operated case, with severe complications (grades IIIb–V based on the Clavien-Dindo classification) observed in 5 women (62.5%). There were no deaths in the early postoperative period. Late complications were observed in a total of 6 women (75.0%), including one death 11 months after palliative exenteration. Conclusions: Despite advances in perioperative care, pelvic exenteration is associated with a high risk of complications which are often life-threatening. The eligibility of patients for this radical surgical approach should be assessed on a case-by-case basis, and the procedure itself should be carried out in a medical center with properly trained staff and medical equipment.

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