Možnosti zvýšené radikality u exenterací pánve

Possibilities of Increased Radicality in Pelvic Exenteration

Objective:
Review of advanced radicality in pelvic exenterations.

Design:
Review article.

Setting:
Department of Obstetrics and Gynecology, General Faculty Hospital and Ist Medical Faculty of the Charles University, Prague.

Methods:
Review and critical assessment of published data.

Conclusions:
More extensive radicality in pelvic exenterations make possible to use surgical treatment in some cases of lateral recurrences or central recurrences with the attachment to the pelvic side wall. One possible technique is a combination of en bloc exenteration with pelvic bone resection, most frequently sacrum. Experiences in gynecological tumours are so far limited. Laterally extended resection was described in lateral infrailiac pelvic wall recurrences. The only one presented paper related to laterally extended procedures showed a reasonable overall survival of patients; however follow-up is limited.

Key words:
pelvic exenteration, laterally extended endopelvic resection, LEER, composite procedures