Technique of the laparoscopic pelvic exenteration

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Abstract

Background: Laparoscopic surgery has proved itself to be a “golden standard” for treatment of most abdominal and retroperitoneal cancers. Such a serious procedure as pelvic exenteration continues to be a complex surgical intervention usually performed through a  conventional laparotomic access. However, studies on minimally invasive approach for this intervention have becoming increasingly published in the world literature.

Aim: To describe the laparoscopic pelvic exenteration technique of pelvic exenteration, as well as to assess short- and long-term results of these interventions.

Materials and methods: From 2011 to 2018, 21 procedures of laparoscopic pelvic exenteration have been performed in 6  surgical centers (Moscow, Russia). Six (6) patients had previously confirmed cervical cancer, 7 patients had bladder cancer, 4 patients had rectal cancer, 1 patient had vaginal cancer, 2 patients had relapsing vaginal cancers after previous uterine extirpation, and 1 patient had an ovarian neoplasm.

Results: The laparoscopic pelvic exenteration volumes were as follows: 9  total, 7 anterior and 5 posterior procedures. In 19 out of 21 cases, negative resection margin (R0) was possible. Median duration of the procedure was 254 minutes, median blood loss was 515 ml, and median postoperative hospital stay was 13 days. Postoperative complications were registered in 6 (28.6%) patients. The 3-year overall survival was 85.71%.

Сonclusion: The choice of laparoscopic access can reduce blood loss, decrease the rates of early postoperative complications, contributes to a more comfortable postoperative period with early activation and less severe pain syndrome, and leads to a reduction in the duration of hospital stay. These results of the laparoscopic technique are comparable with those of laparoscopic and open pelvic exenteration published by other authors.

About the authors

E. A. Galliamov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: fake@neicon.ru

Eduard A. Galliamov – MD, PhD, Professor, Head of the Chair of General Surgery.

8/2 Trubetskaya ul., Moscow, 119991

Russian Federation

R. G. Biktimirov

Clinical Center of Advanced Medical Technologies of the Federal Medical and Biological Agency

Email: fake@neicon.ru

Rafael G. Biktimirov – MD, PhD, Head of the Department of Urology.

Mkr-n Novogorsk, Khimki, Moscow Region, 141435

Russian Federation

V. P. Sergeev

State Research Center – Burnasyan Federal Medical Biophysical Center of the Federal Medical and Biological Agency

Email: fake@neicon.ru

Vladimir P. Sergeev – MD, Head of the Department of Oncological Urology.

23 Marshala Novikova ul., Moscow, 123098

Russian Federation

L. N. Aminova

Joint Stock Company "Medsi group"

Email: fake@neicon.ru

Liana N. Aminova – MD, PhD, Head of Department of Gynecology.

5–3, 5–4 2-y Botkinskiy proezd, Moscow, 125284

Russian Federation

A. E. Sanzharov

Federal Scientific and Clinical Center for Specialized Methods of Medical Care and Medical Technologies of the Federal Medical and Biological Agency

Email: fake@neicon.ru

Andrey E. Sanzharov – MD, Head of the Department of Urology.

28 Orekhovyy bul'var, Moscow, 115682

Russian Federation

M. A. Agapov

Lomonosov Moscow State University Medical Research and Educational Center (Lomonosov University Clinic)

Email: fake@neicon.ru

Mikhail A. Agapov – MD, PhD, Professor, Head of the Department of Surgery No 1.

27/10 Lomonosovskiy prospekt, Moscow, 119991

Russian Federation

D. I. Volodin

State Research Center – Burnasyan Federal Medical Biophysical Center of the Federal Medical and Biological Agency

Email: fake@neicon.ru

Denis I. Volodin – MD, Urologist, Department of Oncological Urology.

23 Marshala Novikova ul., Moscow, 123098

Russian Federation

Е. E. Gallyamov

Federal Scientific and Clinical Center for Specialized Methods of Medical Care and Medical Technologies of the Federal Medical and Biological Agency

Email: fake@neicon.ru

Eduard E. Gallyamov – MD, Surgeon, Oncologist, Department of Urology.

28 Orekhovyy bul'var, Moscow, 115682

Russian Federation

G. Yu. Gololobov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: grriffan@gmail.com

Grigoriy Yu. Gololobov – MD, Surgeon, Department of Surgery.

19/1 Bol'shaya Pirogovskaya ul., Moscow, 119146, tel.: +7 (917) 738 86 89

Russian Federation

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Copyright (c) 2018 Galliamov E.A., Biktimirov R.G., Sergeev V.P., Aminova L.N., Sanzharov A.E., Agapov M.A., Volodin D.I., Gallyamov Е.E., Gololobov G.Y.

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