PELVIC EXENTERATIONS - SUPRALEVATOR, INFRALEVATOR, AND WITH VULVECTOMY

The purpose of this study was to determine whether the different types (I, II, and III) of pelvic exenterations have prognostic implications in regard to operative features, postoperative complications, and sur vival. The records of the 133 patients who underwent pelvic exenterati on at the Mayo Clinic from 1977 to 1986 were reviewed. The records wer e abstracted for duration of hospitalization, febrile morbidity, durat ion of operation, operative blood loss, number of blood transfusions, performance of a perineal phase, development of an omental carpet, vag inal reconstruction, reoperation, additional tissue resection, complic ations, and survival. Statistically significant differences were noted univariately between types I, II, and III in regard to the developmen t of an omental carpet, whether or not vaginal reconstruction was done , the performance of a perineal phase, the resection of additional tis sues, and the duration of hospitalization. The operative and postopera tive morbidity and survival were not influenced significantly by the t ype of exenteration. The subclassification of the exenteration groups into type I (supralevator), type II (infralevator), and type III (with vulvectomy) is helpful to facilitate understanding of the extent of r esection of the pelvic structures and the anatomical changes associate d with each operation. Subgrouping facilitates communication, not only between pelvic surgeons but also with third-party payers. (C) 1997 Ac ademic Press