Laparoscopic Pelvic Exenteration with Bladder Sparing for Men with Locally Advanced Rectal Cancer (with Video)

Objective The aim of this article was to introduce a fascial space priority approach for laparoscopic pelvic exenteration (PE) with bladder-sparing for men with locally advanced rectal cancer. Methods We present a video of bladder-sparing laparoscopic PE with fascial space priority approach in a 70-...

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Bibliographic Details
Published in:Annals of surgical oncology 2022-05, Vol.29 (5), p.3067-3068
Main Authors: Sun, Yi, Yang, Hongjie, Zhang, Zhichun, Zhou, Yuanda, Li, Peng, Zeng, Qingsheng, Fu, Wenzheng, Zhang, Xipeng
Format: Article
Language:English
Subjects:
Aged
Bladder
Chemoradiotherapy
Colorectal Cancer
Humans
Laparoscopy
Laparoscopy - methods
Male
Medicine
Medicine & Public Health
Oncology
Pelvic Exenteration - methods
Prostate
Rectal Neoplasms - pathology
Rectal Neoplasms - surgery
Rectum
Rectum - surgery
Surgery
Surgical Oncology
Tumors
Urinary Bladder - pathology
Urinary Bladder - surgery
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Summary:Objective The aim of this article was to introduce a fascial space priority approach for laparoscopic pelvic exenteration (PE) with bladder-sparing for men with locally advanced rectal cancer. Methods We present a video of bladder-sparing laparoscopic PE with fascial space priority approach in a 70-year old man. The systematic de-arterialization of the prostate on the basis of complete separation of the avascular lateral pelvic spaces is introduced in detail. Results The operation time was 360 min and the estimated intraoperative blood loss was 50 mL. The postoperative course was uneventful and the patient was discharged on postoperative day 14. Histopathological examination showed all margins to be tumor-free. Conclusions Bladder-sparing laparoscopic PE using a fascial space priority approach is a feasible and safe procedure that can be performed in well-selected patients following neoadjuvant chemoradiotherapy. Extensive multivisceral resection is possible without a permanent stoma.
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-021-11222-4