Abstract
We often experience case in which pelvic malignant tumors infiltrate neighboring organs and are forced to perform combined resections for the purpose of complete cure. In an extensive bladder invasion case, total extirpation of the bladder or total pelvic exenteration is performed, and it is remarkable often to see the loss of postoperative QOL by extinction of urinary mechanism. In 51 cases we performed combined bladder resection up to now. Extensive bladder resections were performed in 8 cases of large bowel cancer, one case of ovarian cancer and one case of uterine sarcoma, in total of 10 cases. We performed bladder enlorgement operations in these cases. We used pedicled ileal flaps for reconstruction and performed cystoplasty by Goodwin method. We observed increase of vesical capacity in one month to a year postoperatively by cystometrogram. High compliance was attained with hypobaric urinary retention. The complication of lithogenesis was seen in 2 cases. In the follow up study, the comparison of total exenteration and total bladder extirpation cases did not show significant differences. This operative method seemed to be superior operative method with complete cure characteristics and functions.
