ABSTRACT
Frequency and morbimortality in pelvic exenterations for cervical cancer recurrent after radiation therapy at The Oncology Service, Hospital General de México, SSA., are presented here. Between 1990 to 1994, seventy six patients with this diagnosis, were subjected to surgical exploration with the next findings: forty seven cases, (61.5%) had unresectable tumors; 29, (38.1%) were treated by exenterative procedures: Anterior exenterations, 14, (48.2%); Total exenterations, 13 (44.8%) and Posterior exenteration, 2 (6.8%). Tumor beyond pelvis was the common cause of unresectability in 34 cases, (72.2%) and periaortic lymph node metastases were related with this finding in 29 patients, (61.7%). Thirteen patients with pelvic exenterations, (44.8%) developed postoperative complications between 1 day and seven months after surgery. In seven cases, (24.1%) these complications were considered as minor complications and in six (20.6%) as major complications: Dehiscence of ureteral anastomosis, two cases, (-6.8%); ureterovaginal fistula, two (6.8%); small bowel obstruction, one (3.4%) and Chronic renal failure, one (3.4%). There were no postoperative deaths related to radical surgery in this series. It is concluded that the rate of laparotomies for cervical cancer recurrent after radiation therapy, have decreased in our Service, as compared to previous analysis as well as the rate of postoperative deaths from pelvic exenterations.
