대한대장항문학회

Total pelvic exenteration is an ultra-radical surgical procedure intended for curative<br>treatment of patient with advanced pelvic malignacy primary or recurrent, and offers<br>patients for cure and the possibility of avoiding the horrible death that result from local<br>uncontrolled tumors of the pelvis.<br>From January 1990 to June 1992, 6 patients with pelvic cancer(5 advanced rectal<br>cancer, 1 bladder cancer invased rectum ) were treated with total pelvic exenteration at<br>Department of General Surgery, Yonsei University Wonju College of Medicine. These<br>patients, all men had a median age of 51.1 years. Pathologic staging revealed 3 Dukes'<br>B3 and 3 Dukes' C3. The operative mortality rate was 16.6%. Five complications(wound<br>infection, wound dehiscence, enterocutaneous fistula, G-I bleeding) ocurred in three<br>patients(50%).<br>Two patients died at 17 months, 20 months after operation and three patients are<br>alive(post op. 11 months, 15 months, 17 months) without metastasis to other organ, local<br>recurrence, and are being treated with anticancer chemotherapy.<br>The authors concluded that, although exenteration for colorectal adenocarcinoma may<br>be performed with a low operative mortality rate, patients must be carefully selected<br>because the associated morbidity rate remains high.<br>