and transfer of viable tissue into the pelvis to decrease septic and perineal complications [73, 74]. Moreover, myocutaneous flaps may be used to construct a neovagina [75, 76].
Figure 1.4 Diagrams from the first description by Wanebo and Marcove of abdomino‐prone sacral resection showing the extent of resection required for recurrence of rectal cancer in the posterior compartment (A), lines of transection of the sacrum from the posterior approach (B), the operative defect after sacral resection (C), and rotational skin flaps for wound closure (D). Copyright © 1981 J.B. Lippincott Company.
Source: Reproduced with permission from Wolters Kluwer [49].
Future Directions
The ability to perform radical and extended pelvic cancer surgery is the only potentially curative treatment for patients with locally advanced or recurrent pelvic tumors.
Better diagnostics and chemotherapeutics are likely to be “key” in personalizing patient care, improving survival, or converting unresectable disease to resectable. In addition, there is growing research on quality‐of‐life outcome data following extended radical surgery. This is increasingly becoming as important an outcome measure as survival. The PelvEx Collaborative, offers an unique opportunity to prospectively assess exenterative outcomes, refine treatment options and further improve the management of advanced pelvic malignacies.
Figure 1.5 Gracilis myocutaneous flap for reconstruction of the perineum after PE as described by McCraw et al. in 1976. Copyright © 1976 Plastic & Reconstructive Surgery.
Source: Reproduced with permission from Wolters Kluwer [70].
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