This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Lateral pelvic compartment excision during pelvic exenteration. BJS 2015; 102: 1710-1717.

Published: 8th October 2015

Authors: M. J. Solomon, K. G. M. Brown, C. E. Koh, P. Lee, K. K. S. Austin, L. Masya et al.

Background

Involvement of the lateral compartment remains a relative or absolute contraindication to pelvic exenteration in most units. Initial experience with exenteration in the authors' unit produced a 21 per cent clear margin rate (R0), which improved to 53 per cent by adopting a novel technique for en bloc resection of the iliac vessels and other side‐wall structures. The objective of this study was to report morbidity and oncological outcomes in consecutive exenterations involving the lateral compartment.

Method

Patients undergoing pelvic exenteration between 1994 and 2014 were eligible for review.

Results

Two hundred consecutive patients who had en bloc resection of the lateral compartment were included. R0 resection was achieved in 66·5 per cent of 197 patients undergoing surgery for cancer and 68·9 per cent of planned curative resections. For patients with colorectal cancer, a clear resection margin was associated with a significant overall survival benefit (P = 0·030). Median overall and disease‐free survival in this group was 41 and 27 months respectively. Overall 1‐, 3‐ and 5‐year survival rates were 86, 46 and 35 per cent respectively. No predictors of survival were identified on univariable analysis other than margin status and operative intent. Excision of the common or external iliac vessels or sciatic nerve did not confer a survival disadvantage.

Conclusion

The continuing evolution of radical pelvic exenteration techniques has seen an improvement in R0 margin status from 21 to 66·5 per cent over a 20‐year interval by routine adoption of a more lateral anatomical plane. Five‐year overall survival rates are comparable with those for more centrally based tumours.

Full text

You may also be interested in

Leading article

Network meta‐analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia.

Authors: J. H. H. Olsen, S. Öberg, K. Andresen, T. W. Klausen, J. Rosenberg

Original article

Outcomes of surgery for benign and malignant adrenal disease from the British Association of Endocrine and Thyroid Surgeons’ national registry. BJS 2019; 106: 1495-1503.

Authors: N. Patel, R. J. Egan, B. R. Carter, D. M. Scott‐Coombes, M. J. Stechman, A. Afzaal et al.

Lateral pelvic compartment excision during pelvic exenteration. BJS 2015; 102: 1710-1717.

Background

Method

Results

Conclusion

You may also be interested in

A good surgical death. BJS 2019; 106: 1427-1428.

Randomized controlled trial of plain English and visual abstracts for disseminating surgical research via social media.

Systematic review of the current status of cadaveric simulation for surgical training.

Network meta‐analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia.

Effect of donor nephrectomy time during circulatory‐dead donor kidney retrieval on transplant graft failure.

Trauma models to identify major trauma and mortality in the prehospital setting.

Diagnostic performance of MRI and histology in assessment of deep lipomatous tumours.

Dysregulation of the actin scavenging system and inhibition of DNase activity following severe thermal injury.

5G‐assisted telementored surgery.

Validation of the Norwegian survival prediction model in trauma (NORMIT) in Swedish trauma populations.

Human model of burn injury that quantifies the benefit of cooling as a first aid measure. BJS 2019; 106: 1472-1479.

Outcomes of surgery for benign and malignant adrenal disease from the British Association of Endocrine and Thyroid Surgeons’ national registry. BJS 2019; 106: 1495-1503.