Pelvic Exenteration with Preservation of Urinary and Anal Sphincter Functions

Abstract

A novel reconstruction method following pelvic exenteration was reported. A 60-year-old male with sigmoid colon cancer that infiltrated to the seminal vesicle, middle rectum, and trigone of the bladder underwent curative pelvic exenteration with preservation of urinary and anal sphincter functions. Ileal neobladder was anastomosed to the urethra close to the external sphincter, whereas the double stapling method was used for the anal canal and descending colon anastomoses, resulting in stomaless reconstruction. Several types of tube drainage, especially the use of tube caecostomy and trans-gastric ileus tube that prevented defecation and flatus for 14 days following the operation, were employed for protection against anastomotic leakage.Major omentum was packed in the pelvis for fixation of the anastomoses and for prevention of postoperative pelvic abscess. The quality of life of this patient was significantly better than that usually seen in conventional reconstruction using double stoma. The technical issue and indication of this reconstruction method were discussed.