A Study on Postoperative Complications and the Treatment of Pelvic Exenteration with Combined Resection of Urinary Bladder and Sacrum for Colorectal Cancer.

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51 cases of pelvic exenteration for advanced (31 cases) or recurrent colorectal cancer (20 cases) performed in our department from 1975 to 1992 were reviewed. They were divided into three groups, 28 cases of partial pelvic exenteration as group-1, 14 cases of total pelvic exenteration as group-2 and 9 total pelvic exenteration with sacrum resection as group-3. The ratio of postoperative complication was 32.1 % in group-1, 42.9 % in group-2 and 88.9 % in group-3, it was significantly higher in the extended operation group. In group-1, complications such as-ileus etc. were seen 25 % of the patients. These complications were mostly not serious. Pelvic dead space inflammation which was frequently found (78 %) in group-3 was effectively cured by irrigation of pelvic dead space with saline containing antibiotics in early time of postoperative period, and by musculocutaneous flap implantation in two patients. Complications in urinary system were found in about 20 % of the patients both in group-2 and group-3 with no significant difference between the two groups. The main complication in ureterocutaneous fistula cases was urinary infection or urinary calculus, these complications could be controlled with frequent ureteral catheter replacement and antiboitics or the stone removal. Urinary fistula complicated in ileal conduit cases could be controlled with nephrostomy. There were few effective treatment for severe complications like the enteral fistula or the line dehiscence of the ileoilealanastomosis. It is important to be careful about the operative technique and postoperative care to prevent from the occurence of these severe complications.
日本大腸肛門病学会の論文

A Study on Postoperative Complications and the Treatment of Pelvic Exenteration with Combined Resection of Urinary Bladder and Sacrum for Colorectal Cancer.

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