経恥骨的腹会陰連続切開法による骨盤内臓器全摘術の1例

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  • A CASE REPORT OF TOTAL PELVIC EXENTERATION WITH SYMPHYSIOTOMY

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We report a case of the transpubic total pelvic exenteration. A 57-year-old man was admitted to the hospital because of bloddy stool and fever. A rectal cancer 10cm in diameter at the level of 1.5cm above the anus invaded the vesical bladder and the prostate. There was no distant metastasis. He underwent a total pelvic exentration on January 31, 1996. A midline abdominal incision was extended to the perineum, the symphysis pubis was sectioned, and the pubic bones were retracted laterally. By the symphysiotomy the exposure for operation was remarkably improved and the total pelvic exanteration was performed more easily nd safely. After this procedure there were not any orthopedic complicatiosn. This patient did not undergo any adjuvant chemotherapy for his refusal. Six months later he was admitted again because of a local reccurence. This method has some demerits. The external genital organ has to be resected for the interruption in blood circulation. The pain in sacroiliac articulation sometime occurs. But there are greater merits as said above. We think this is an excellent procedure espesially for obese patients, patients with massively enlarged tumor and with a narrow pelvis.

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