Clinical Application And Significance Of Total Pelvic Exenteration

OBJECTIVEThe combined pelvic exenteration(TPE)was carried out in patients with pelvic tumors.METHODSFrom 2008 to 2018,we chose 90 patients who were diagnosed with a wide range of pelvic invasions such as rectal cancer,cervical cancer,ovarian cancer,prostate cancer,and giant pelvic malignant tumors,of which 45 were experimental and 45 were control.group.The experimental group included 26 patients with rectal cancer and recurrent rectal cancer with direct pelvic infiltration and metastatic cancer.9 patients with recurrent cervical cancer after radical surgery and recurrence with extensive pelvic metastatic cancer after other treatment methods;2 patients with vaginal metastatic cancer;One patient with extensive pelvic metastatic carcinoma of prostate cancer;1 patient with extrapelvic neurosarcoma accompanied by a large pelvic cavity and infiltration;After the operation of pelvic leiomyosarcoma,one patient with extensive pelvic metastasis was treated with other methods.There were five patients with recurrent ovarian cancer after radical surgery accompanied by extensive pelvic metastatic cancer.The control group included 28 patients with rectal cancer and recurrent rectal cancer with direct pelvic infiltration and metastatic cancer.There were 8 patients with recurrence after radical operation of cervical cancer and recurrence with extensive pelvic metastatic carcinoma after other treatment methods.2 patients with vaginal metastatic cancer;One patient with extensive pelvic metastatic carcinoma of prostate cancer;There were 6 patients with recurrent ovarian cancer after radical surgery accompanied by extensive pelvic metastatic cancer.The experimental group took total pelvic organ resection,and the control group was only conservative treatment(that is,no full pelvic organ resection was taken).The two groups of patients were compared and analyzed.The survival rates of 3 months,6 months,1 year,3 years and 5 years of patients with total pelvic organ resection and without total pelvic organ resection were studied and compared.RESULTSA total of 26 patients in the 45 experimental group had rectal cancer and recurrent rectal cancer accompanied by extensive pelvic metastatic cancer.Among them,10 patients had undergone palliative surgery and the remaining patients had undergone radical surgery.The survival rate of postoperative patients:14 in 1 year,reaching 53.8%;8 in 3 years,reaching 30.7%;4 in 5 years,reaching 15.3%.There were 9 patients who had a recurrence after radical cervical cancer surgery and had a recurrence with extensive pelvic metastatic cancer after other treatments.The survival rate of postoperative patients:6 in 1 year,reaching 66%;3 in 3 years,reaching 33%;No surviving patient for 5 years.There were 5 patients with recurrent o’varian cancer with pelvic metastatic cancer.The survival rate of postoperative patients was:1 year and 5 patients,that is,100%;3 times in 3 years,reaching 60%;2 in 5 years,reaching 40%.The survival rate of 45 patients with the same disease in the control group was:19 in 3 months,reaching 42%;4 in 6 months,or 8.9%;One year without surviving patients,all died.CONCLUSIONThe total pelvic viscera combined resection has a large area of trauma and a high risk factor.At present,it is the best treatment for pelvic malignant tumors such as rectal cancer and uterine cancer.TPE surgery is very important for rectal cancer in the pelvic cavity.Most patients can use TPE to relieve pain and prolong life,and even some of the diseases will be completely cured.In the clinical development of cancer patients in the pelvic cavity,TPE treatment should be actively carried out when the cancer does not spread,effectively reducing the complications caused by the operation and the disease,and improving the quality of life of the patient.help.