Total Pelvic Exenteration In Locally Recurrent Rectal Cancer:A Case Report And Review Of The Literature

Objective: 1.To analyze the clinical features of locally recurrent rectal cancer and to improve the understanding of the disease.2.To explore the role of total pelvic exenteration in the treatment of locally recurrent rectal cancer.Methods: Collected the clinical data of 1 case of rectal cancer with local recurrence after comprehensive treatment in our hospital in 2009 in detail and followed up;Searched the cases reported in 2001~2018 on PubMed,Wan fang,CKNI,and VIP database.combined with clinical practice,analyzed and summarized the databases.Results: 1.locally recurrent rectal cancer often occurred 8-22 months after radical operation;radiotherapy alone or combined chemotherapy can extend the median survival to 12-15 months,and the 5-year survival rate is less than 10%;The 5-year survival rate of the R0 resection patients can reach about 50%,which is much higher than that of non-R0 resection patients.2.locally recurrent rectal cancer involves multiple disciplines,should be treated under the multidisciplinary therapy(MDT).3.this patient was by total pelvic exenteration,followed up for 1 year and 4 months,no recurrence and metastasis of the pelvic cavity,survived to this day.4.the patient’spostoperative quality of life has been greatly improved,in addition to the need to care for the abdominal double stoma,the patient has no pain in the appendix,occasionally in the groin area,no pain in the appendix,no difficulty in urinary defecation.5.Retrospective analysis of 644 patients with total pelvic exenteration in the treatment of locally recurrent rectal cancer,the majority of patients with pelvic recurrence and metastasis,clinical symptoms were significantly improved,and the survival period was significantly prolonged.Conclusion: The cases of locally recurrent rectal cancer are rare in clinical practice,involving multiple organs,and the tumor has been advanced,causing serious damage to the patient.There is no uniform standard of treatment.In the MDT mode,the total pelvic exenteration is performed,which makes the patient get a higher R0 resection rate.Adjuvant chemotherapy or targeted therapy is still recommended after surgery.The patient is optimally treated and the pelvic local lesions are controlled.