Exenteração pélvica e preservação dos esfíncteres: análise de 96 casos / Pelvic exenteration and sphincter preservation: an analysis of 96 cases

RESUMO

A exenteração pélvica é método efetivo no tratamento de tumores pélvicos localmente avançados. As cirurgias mais conservadoras, com preservação funcional dos esfíncteres e reconstrução continente dos tratos intestinal e urinário podem melhorar a qualidade de vida e estimular os pacientes a aceitar a cirurgia. O objetivo deste estudo foi avaliar os resultados da exenteração pélvica no tratamento dos tumores pélvicos localmente avançados em relação à preservação dos esfícteres e fatores associados ao prognóstico. Com os resultados deste estudo podemos concluir que houve aumento da frequência de margens cirúrgicas comprometidas nem prejuízo na sobrevida dos pacientes submetidos à exenteração pélvica com preservação dos esfíncteres / Pelvic exenteration (PE) is an effective method for treating locally advanced pelvic tumors. More conservative surgeries, preserving sphincteres and continent reconstruction of the intestinal and urinary tarct, which could contribute to a better quality of life and encourage patients to accept this procedure. The objective of this study was to evaluate the results of PE in the treatment of locally advanced pelvic tumors, mainly considering sphincter preservation and factors associated to rhe prognosis. Between 1980 and 2000, 96 PE were performed. Factors related tosphincter preservation as well as factors associated to prognosis were respectively analyzed. Of the 96 patients treated with pelvic exenteration, at least one sphincter in 36 patients was preserved (37.5per cent) in the 1990's, the sphincter preservation rate was significantly higher than in the 1980's and coloproctogical tumors...