WordNet

of or near the head end or toward the front plane of a body
earlier in time (同)prior
of or relating to the pelvis; "pelvic exam"; "pelvic inflammation"
surgical removal of the organs within a body cavity (as those of the pelvis)

PrepTutorEJDIC

(場所などが)前の,前部の;(…より)前に位置する《+『to』+『名』》 / (時・事件などが)以前の,先の;(…より)前の《+『to』+『名』》
骨盤の

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/13 22:58:51」(JST)

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Pelvic exenteration (or pelvic evisceration) is a radical surgical treatment that removes all organs from a person's pelvic cavity. The urinary bladder, urethra, rectum, and anus are removed.

The procedure leaves the person with a permanent colostomy and urinary diversion. In women, the vagina, cervix, uterus, fallopian tubes, ovaries, and in some cases the vulva are removed. In men, the prostate is removed.

Indications

Pelvic exenteration is most commonly used in cases of very advanced or recurrent cancer, in which less radical surgical options are not technically possible or would not be sufficient to remove all the tumor. This procedure is performed for many types of cancer including genitourinary and colorectal cancers.

Recent literature has shown that pelvic exenteration can provide long-term survival for patients with locally advanced primary rectal carcinoma. The 5-year survival rate of patients undergoing pelvic exenteration following complete resection of disease was 59·3%. A number of factors have been shown to influence the survival rates following a pelvic exenteration procedure. These include age, the presence of metastatic disease, lymph node status, circumferential resection margin, local recurrence of disease, and the need for neoadjuvant therapy. ^[1]

Complications

After pelvic exenteration, many patients will have perineal hernia, often without symptoms, but only 3–10% will have perineal hernia requiring surgical repair.^[2]

History

The procedure was first described by Alexander Brunschwig in 1948.^[3]^[4]

References

^ Radwan RW, et al. Determinants of survival following pelvic exenteration for primary rectal cancer. Br J Surg. 2015 Jun 11. doi: 10.1002/bjs.9841.
^ Berman L, Aversa J, Abir F, Longo WE (July 2005). "Management of disorders of the posterior pelvic floor". Yale J Biol Med 78 (4): 211–21. PMC 2259151. PMID 16720016.
^ Brunschwig A: Complete excision of the pelvic viscera for advanced carcinoma. Cancer 1948; 1: 177.
^ med/3332 at eMedicine

UpToDate Contents

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1. 婦人科癌に対する摘除術 exenteration for gynecologic cancer
2. 限局進行性の切除不能または再発性直腸腺癌の治療 treatment of locally advanced unresectable or recurrent rectal adenocarcinoma
3. 女性における尿道癌 urethral cancer in women
4. 原発性直腸癌に対する手術の概要 overview of surgery for the treatment of primary rectal adenocarcinoma
5. 女性における術後尿閉 postoperative urinary retention in women

English Journal

Prognostic factors in pelvic exenteration for gynecological malignancies.

Baiocchi G, Guimaraes GC, Rosa Oliveira RA, Kumagai LY, Faloppa CC, Aguiar S, Begnami MD, Soares FA, Lopes A.SourceDepartment of Gynecologic Oncology, AC Camargo Cancer Hospital, Sao Paulo, Brazil. Electronic address: glbaiocchi@yahoo.com.br.
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.Eur J Surg Oncol.2012 Oct;38(10):948-54. doi: 10.1016/j.ejso.2012.07.002. Epub 2012 Jul 18.
OBJECTIVES: Analyze morbidity, mortality and prognostic factors after pelvic exenteration (PE) for gynecological malignancies.METHODS: We reviewed a series of 107 individuals who underwent PE at A.C. Camargo Cancer Hospital from August 1982 to September 2010.RESULTS: Median age was 56.4 years. Prima
PMID 22818842

Japanese Journal

大腸全摘後，遺残尿道瘻が原発と考えられる癌の発生をみたクローン病の一症例

伊藤太祐,稲次直樹,吉川周作,増田勉,榎本泰三,内田秀樹,久下博之,大野隆,横谷倫世,山岡健太郎,下林孝好,稲垣水美,横尾貴史,植田剛,武内拓,小山文一,藤井久男,中島祥介,榎本泰典,大林千穂
日本大腸肛門病学会雑誌 67(4), 279-284, 2014
遺残尿道瘻より癌が発生したと思われるクローン病症例を経験したので報告する．患者は30歳代男性．12歳時に発症した多発性難治性複雑痔瘻を併発した大腸クローン病症例で19歳時に回盲部十二指腸瘻を形成，結腸全摘・十二指腸瘻孔部縫合閉鎖・回腸直腸吻合術施行．術後クローン病再発による回腸直腸吻合部・回腸・直腸・肛門周囲に多発性瘻孔を形成，再手術で直腸切断術・永久回腸ストーマ造設術施行．術後尿道瘻が遺残，直腸 …
NAID 130003394592

膣，子宮頸部，膀胱，尿管への進展を認め前方骨盤除臓術を行った再発性外陰部Paget病の1例

楠谷尚,吉川周佐,加藤元一,嵩眞佐子,庭川要,高橋伸卓,清原祥夫
Skin Cancer 28(1), 84-88, 2013
56歳，女性。2005年頃から外陰部の掻痒，紅斑を自覚した。2007年に近医での生検にて外陰部Paget病と診断され，当科紹介受診となった。病変は恥丘部から肛門部にかけて存在しており，同年12月に腫瘍切除，植皮術を施行した。2011年8月に頻尿，排尿時痛が出現し，近医泌尿器科にてPaget病再発の可能性を指摘された。外尿道口周囲から膣口にびらんを伴う紅斑があり，膀胱鏡検査では膀胱頸部に紅斑が認めら …
NAID 130003378173

膀胱拡大術後38年目に発症した膀胱拡大部S状結腸癌の1例

竹澤健太郎,奥見雅由,中山雅志 [他],宮川康,瀧内剛,木村正,大橋寛嗣,野々村祝夫
泌尿器科紀要 57(6), 327-330, 2011-06
… An anterior pelvic exenteration was performed with preoperative diagnosis of left ovarian cancer with peritoneal dissemination. …
NAID 40018861647

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