Laterally extended endopelvic resection:: Surgical treatment of infrailiac pelvic wall recurrences of gynecologic malignancies
Laterally extended endopelvic resection:: Surgical treatment of infrailiac pelvic wall recurrences of gynecologic malignancies
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DOI：
10.1016/s0002-9378(99)70204-8
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发表时间：
1999-02-01
影响因子：
9.8
通讯作者：
Höckel, M
中科院分区：
文献类型：
--
作者：
Höckel, M
目的：我的目的是治疗髂下盆腔壁复发的妇科恶性肿瘤扩大根治性surgery.Study Design：尸体解剖研究的基础上，我开发了横向扩展的盆腔内切除技术。在3年的可行性study.Results：外侧延长的盆腔内切除术延长外侧切除平面盆腔清除术的内侧方面的髋臼，闭孔膜，骶棘韧带，骶丛/梨状肌的患者提供了新的操作进行了连续18例。在此手术后，所有患者均从肿瘤床区域内的剩余骨盆壁结构中采集无肿瘤术中活检标本。最终的组织病理学报告证实6例患者边缘干净，12例患者边缘仅存在显微镜下肿瘤扩展。严重并发症发生在4例（22%），没有治疗相关的deaths.CONCLUSION：横向扩大盆腔内切除术允许完全的手术切除髂下盆腔侧壁肿瘤，最常见的局部复发的下生殖道癌，无论是与自由的边缘或潜在的显微镜下残留肿瘤作为一个先决条件，联合手术和放射治疗。
OBJECTIVE: My purpose was to treat infrailiac pelvic wall recurrences of gynecologic malignancies with extended radical surgery.STUDY DESIGN: On the basis of cadaver dissection studies, I developed the laterally extended endopelvic resection techniques. The new operations were offered to patients with infrailiac sidewall disease during a 3-year feasibility study.RESULTS: Laterally extended endopelvic resections extending the lateral resection plane of pelvic exenteration to the medial aspects of the acetabulum, obturator membrane, sacrospinous ligament, and sacral plexus/piriformis muscle were performed in 18 consecutive patients. After this procedure, all patients had tumor-free intraoperative biopsy specimens taken from the remaining pelvic wall structures within the tumor bed area. The final histopathologic report confirmed clean margins in 6 patients and margins with microscopic tumor extensions only in 12 patients. Severe complications occurred in 4 patients (22%), without treatment-related deaths.CONCLUSION: Laterally extended endopelvic resection allows the complete surgical removal of infrailiac pelvic-side-wall tumors, the most frequent local recurrence of lower genital tract cancer, either with free margins or with potential microscopic residual tumor as a prerequisite for combined operative and radiation treatment.