INDICATION AND LIMITATION OF TOTAL PELVIC EVISCERATION (TPE) FOR COLORECTAL CANCER

Abstract

Indication and limitation of total pelvic evisceration (TPE) were evaluated in 113 patients with colorectal cancer (Si, Ai) invading the adjacent structures and 33 patients with local recurrence in the pelvic cavity underwent surgery during 1959 to May, 92'. TPE was performed in 21 patients (11 with primary cancer and 10 with recurrence). The si, ai rate in 113 patients with primary cancer (Si, Ai) was as low as 55.8%, however si, ai, rate in uterus, vagina and ureter was as high as more than 75%. Cumulative 5-year survival rate in resected cases combined with pelvic organ was 57.9% (TPE cases: 59.9%, non TPE cases: 56.6%), which was significantly higher than 10.6% in no combined cases.
It is concluded that a case, which is diagnosed as Si, Ai by preoperative dynamic CT and MRI, and has no dissemination and distant organ metastasis, with lymph node metastasis of less than N₂, can be considered a possible candidate for TPE combined with sacral resection, entertaining a lack in ew.