International Medical Journal, Vol. 22., Iss. 2, 2016, P. 18−25.
COMBINED OPERATIONS IN COMPLICATED AND LOCALLY ADVANCED PELVIC CANCER TUMORS
V. T. Zaytsev Institute of General and Urgent Surgery NAMS of Ukraine, Kharkiv, Ukraine
The authors present the analysis of results of surgical treatment of 78 patients with locally advanced tumors of the pelvic organs complicated by involvement of the adjacent organs. The tumors were complicated by invasion of the urinary tract with formation of enteric−vesical, intestinal−vaginal or vaginal−vesical fistula (45 patients) and unilateral (8 patients) or bilateral ureterohydronephrosis (4 patients). The primary tumor location was as follows: 45 patients −− adenocarcinoma of the rectum and sigmoid colon, 15 −− squamous cervical cancer, 12 −− ovarian cancer, 6 −−− pelvic sarcoma. Of 78 cases of tumor invasion into the adjacent pelvic organs, posterior pelvic exenteration (intestine resection with hysterectomy) was performed in 34 cases, resection of the bladder and ureters was performed in 34 cases. Five cases underwent total pelvic exenteration, 2 −− colostomy. Two−stage operation was performed in 18 cases, one−stage in 58. Histological examination of removed tumors in 67 of 76 patients (88.1 %) indicated the true invasion of the adjacent organs, while inflammatory infiltration of the body wall occurred in 9 (11.9 %) patients. In 92.2 % of patients, resection margins investigation indicated radically performed partial exenteration (absence of cancer cells in the resection margin). Surgical treatment of this disease with a high degree of radical removal of the primary tumor can be achieved by combined surgical interventions in cases of staged surgical tactics and syndrome approach.
Key words: locally advanced pelvic cancer, fistulas, combined operations.