Gastrointestinal complications associated with pelvic exenteration

James W. Orr, Hugh M. Shingleton, Kenneth D. Hatch, Peyton T. Taylor, Edward E. Partridge, Seng Jaw Soong

Research output: Contribution to journalArticle

59 Scopus citations

Abstract

Between October 1969, and August 1981, 125 pelvic exenterations were performed by gynecologic oncologists at the University of Alabama in Birmingham. One hundred twenty patients underwent an exenterative procedure that required urinary diversion and a gastrointestinal anastomosis. Gastrointestinal complications accounted for 60% of all nonmalignant indications for reoperation after exenteration. The common factor in the majority of gastrointestinal complications was the presence of an anastomosis in previously irradiated small bowel. Other preoperative factors, such as significant medical disease, previous laparotomy, or malnutrition, had little apparent effect on the rate of gastrointestinal complications. Avoidance of a small bowel anastomosis by means of a colon conduit, use of an omental pedicle to bring new blood supply into the pelvis, and hyperalimentation have reduced the risk of small bowel obstruction and fistula to 2.2%, while alteration in surgical technique has decreased the rectovaginal fistula rate to 5.3%.

Original languageEnglish (US)
Pages (from-to)325-332
Number of pages8
JournalAmerican journal of obstetrics and gynecology
Volume145
Issue number3
DOIs
StatePublished - Feb 1 1983
Externally publishedYes

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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