2Table 2.1 Differences between hospitals caring for “regular” colorectal canc...
2 Chapter 3Table 3.1 Existing classification systems for pelvic compartments.Table 3.2 The St. Mark’s roadmap approach for assessment of pelvic tumor ana...Table 3.3 Construction of the roadmap for R0 resection in patient 1.
3 Chapter 5Table 5.1 Nutritional Risk Screening (based on NRS‐2002) [4].
4 Chapter 7Table 7.1 Checkpoints for proceeding at the intraoperative stage.Table 7.2 Planes of unexpected tumor extension and potential strategies for...
5 Chapter 8Table 8.1 Complications after anterior pelvic exenteration.
6 Chapter 9Table 9.1 Pelvic and abdominal organs to be removed during posterior pelvic ...Table 9.2 Postoperative complications after posterior pelvic exenteration (n...Table 9.3 Prognosis after posterior pelvic exenteration.
7 Chapter 10Table 10.1 Contraindications for TPE.
8 Chapter 11Table 11.1 Bony exenteration: indications and contraindications.Table 11.2 Series of en‐bloc sacrectomy for recurrent rectal adenocarcinoma...
9 Chapter 18Table 18.1 Surgical checklist for pelvic exenteration.
10 Chapter 20Table 20.1 Common quality of life (QoL) instruments and other health‐relate...Table 20.2 Evidence of quality of life (QoL) following pelvic exenteration.
11 Chapter 21Table 21.1 Landmark studies of adjuvant chemotherapy in rectal cancer after...Table 21.2 Ongoing clinical trials of immune checkpoint inhibitors in locor...
12 Chapter 24Table 24.1 Patient and previous radiotherapy characteristics.Table 24.2 Re‐irradiation details and outcome.
13 Chapter 25Table 25.1 Reported indications for PPES.Table 25.2 Historical overview of selected series in the English literature...
14 Chapter 26Table 26.1 Contraindications for LARC and LLRC.Table 26.2 Outcomes associated with pelvic exenteration for LARC.
15 Chapter 27Table 27.1 Outcomes of PE due to bladder cancer.Table 27.2 General and specific complications of exenterative surgery.
16 Chapter 28Table 28.1 Considered contraindications.Table 28.2 Complications after PE for gynecological malignancies.Table 28.3 Survival after PE for gynecological malignancies.
17 Chapter 29Table 29.1 Musculoskeletal Tumor Society (MSTS) [8] staging system for bone...Table 29.2 American Joint Committee on Cancer (AJCC 8th Edition) [9] stagin...Table 29.3 American Joint Committee on Cancer (AJCC 8th Edition) [9] stagin...
List of Illustrations
1 Chapter 1Figure 1.1 (a) Levels of transection of the ureters (U) and colon (C) and in...Figure 1.2 Diagram from Bricker’s original article on urinary diversion demo...Figure 1.3 Evolution of pelvic exenterative surgery.Figure 1.4 Diagrams from the first description by Wanebo and Marcove of abdo...Figure 1.5 Gracilis myocutaneous flap for reconstruction of the perineum aft...
2 Chapter 2Figure 2.1 National registries help to monitor outcome. In this control char...
3 Chapter 3Figure 3.1 Sagittal MRI showing presacral fluid collection surrounded by a t...Figure 3.2 (a) Axial MRI at the level of S1 nerve roots. (b) Right S1 nerve ...Figure 3.3 (a) Axial MRI at the level of ischial spine. (b) Gross involvemen...Figure 3.4 (a) Axial MRI at the level of the piriformis muscle. (b) The ante...Figure 3.5 (a) Axial MRI at the level of the SGA. (b) A “tongue” of tumor cl...Figure 3.6 Coronal MRI showing tethering of the uterus and rectum by tumor/f...Figure 3.7 (a) Axial MRI at the level of the distal ureters. (b) The right u...
4 Chapter 5Figure 5.1 Preoperative care.
5 Chapter 7Figure 7.1 T2‐turbo spin echo (TSE) MRI and corresponding photograph demonst...Figure 7.2 T2 MRI demonstrating an anteriorly based rectal tumor invading th...
6 Chapter 8Figure 8.1 Sagital view of a total pelvic exenteration in the male (left) an...
7 Chapter 9Figure 9.1 Local recurrence of a rectal cancer with infiltration of the uter...Figure 9.2 Overall survival after curative (R0) and non‐curative (R1, 2, X) ...
8 Chapter 10Figure 10.1 Coronal MRI of the pelvis demonstrating extensive primary rectal...Figure 10.2 .Resection margins for TPE as demonstrated on a sagittal MRI sca...Figure 10.3 Male TPE specimen, including rectum, bladder, and prostate. Note...Figure 10.4 Female TPE specimen, shown from below, demonstrating opening int...
9 Chapter 11Figure 11.1 Colorectal metastasis to S2/3.Figure 11.2 Postoperative MRI following S1/2 sacrectomy.Figure 11.3 CT‐PET showing involvement of the distal sacrum with recurrent r...
10 Chapter 12Figure 12.1 MRI demonstrates the extent of a locally advanced primary rectal...Figure 12.2 This case illustrates a recurrent rectal cancer involving the ri...
11 Chapter 13Figure 13.1 Recurrent rectal cancer involving S2 and S3. A high sacrectomy w...Figure 13.2 Recurrence mainly involving S2, but a small deposit in the anter...Figure 13.3 Invasion of S1 suitable for resection of the anterior table of t...Figure 13.4 Bulky but low recurrence that required resection of right pirifo...Figure 13.5 Left pelvic sidewall recurrence that had responded to preoperati...Figure 13.6 Upper sacral (S1 and S2) involvement with spread across the left...
12 Chapter 17Figure 17.1 Dehiscence of an irradiated perineal wound.Figure 17.2 (a,b) Vertical rectus muscle flap raised and running on the infe...Figure 17.3 (a,b) Myocutaneous gracilis flap raised with its perforator bloo...Figure 17.4 Bilateral inferior gluteal artery perforator flaps. Area to be d...Figure 17.5 Recurrent anal SCC with urethro‐perineal fistulation. Pelvic exe...
13 Chapter 18Figure 18.1 Preoperative perineum setup, with skin marking to indicate inten...Figure 18.2 Exposure of the aortic bifurcation and common iliac confluence....Figure 18.3 Transected ureters drained by pediatric feeding tubes.Figure 18.4 The empty pelvis following total exenteration with partial sacre...
14 Chapter 19Figure 19.1 MRI used for planning surgery at the pelvic side wall.
15 Chapter 20Figure 20.1 Quality of life following pelvic exenteration.Figure 20.2 Functional, physical, and mental component scores following pelv...
16 Chapter 21Figure 21.1 Three‐dimensional conformal radiotherapy plan with belly board w...Figure 21.2 Treatment algorithm for LARC and LRRC with regard to exenteratio...
17 Chapter 26Figure 26.1 Intraoperative locally advanced tumor via multivisceral resectio...Figure 26.2 Total pelvic exenteration specimen.Figure 26.3 IORT to the pelvic sidewall following resection of a locally adv...Figure 26.4 En‐bloc sacrectomy in the setting of LARC.
18 Chapter 27Figure 27.1 Kaplan–Meier survival for locally advanced T4 bladder cancer: PE...Figure 27.2 Kaplan–Meier