التفاصيل البيبلوغرافية
| العنوان: |
Bladder preservation or complete cystectomy during pelvic exenteration of patients with locally advanced or recurrent rectal cancer, what should we do? |
| المؤلفون: |
Palma, Catalina A., van Kessel, Charlotte S., Solomon, Michael J., Leslie, Scott, Jeffery, Nicola, Lee, Peter J., Austin, Kirk K.S. |
| المصدر: |
European Journal of Surgical Oncology; Jul2023, Vol. 49 Issue 7, p1250-1257, 8p |
| مصطلحات موضوعية: |
PELVIC exenteration, RECTAL cancer, CYSTECTOMY, CANCER patients, BLADDER cancer, ILEAL conduit surgery, PERINEAL care |
| مستخلص: |
In patients with locally advanced (LARC) or locally recurrent (LRRC) rectal cancer and bladder involvement, pelvic exenteration (PE) with partial (PC) or radical (RC) cystectomy can potentially offer a cure. The study aim was to compare PC and RC in PE patients in terms of oncological outcome, post-operative complications and quality-of-life (QoL). This was a retrospective cohort analysis of a prospectively maintained surgical database. Patients who underwent PE for LARC or LRRC cancer with bladder involvement between 1998 and 2021 were included. Post-operative complications and overall survival were compared between patients with PC and RC. 60 PC patients and 269 RC patients were included. Overall R0 resection was 84.3%. Patients with LRRC and PC had poorest oncological outcome with 69% R0 resection; patients with LARC and PC demonstrated highest R0 rate of 96.3% (P = 0.008). Overall, 1-, 3- and 5-year OS was 90.8%, 68.1% and 58.6% after PC, and 88.7%, 62.2% and 49.5% after RC. Rates of urinary sepsis or urological leaks did not differ between groups, however, RC patients experienced significantly higher rates of perineal wound- and flap-related complications (39.8% vs 25.0%, P = 0.032). PC as part of PE can be performed safely with good oncological outcome in patients with LARC. In patients with LRRC, PC results in poor oncological outcome and a more aggressive surgical approach with RC seems justified. The main benefit of PC is a reduction in wound related complications compared to RC, although more urological re-interventions are observed in this group. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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