RESUMEN
Anal squamous cell carcinoma, typically associated with human papillomavirus infection, remains a rare malignancy. This article outlines a case of local recurrence in a male patient with a history of HIV and hepatitis C virus infection, previously treated with chemoradiotherapy. Extensive tumour involvement called for total pelvic exenteration extended to anterior osteomuscular compartment and genitalia. The surgical approach involved multidisciplinary collaboration and detailed preoperative planning using three-dimensional reconstruction. Key surgical considerations comprised the following: achieving tumour-free margins (R0 resection), extensive osteotomies and intricate pelvic floor reconstruction with prosthetic mesh and flap reconstruction. The procedure successfully yielded an R0 resection, maintaining adequate lower limb functionality. Our case report underscores the benefits of pelvic exenteration in locally advanced or recurrent pelvic tumours, invariably following careful patient selection and exhaustive preoperative studies.
Asunto(s)
Neoplasias del Ano , Carcinoma de Células Escamosas , Quimioradioterapia , Recurrencia Local de Neoplasia , Huesos Pélvicos , Exenteración Pélvica , Procedimientos de Cirugía Plástica , Colgajos Quirúrgicos , Humanos , Masculino , Neoplasias del Ano/terapia , Neoplasias del Ano/cirugía , Carcinoma de Células Escamosas/terapia , Carcinoma de Células Escamosas/cirugía , Recurrencia Local de Neoplasia/cirugía , Quimioradioterapia/métodos , Huesos Pélvicos/cirugía , Procedimientos de Cirugía Plástica/métodos , Persona de Mediana EdadRESUMEN
Preoperative progressive pneumoperitoneum has represented an important advancement in achieving the reintroduction of large herniated volumes into the abdominal cavity. However, this technique is not free of complications. We present a case of a man in his 70s with an accidental peritoneal-cutaneous fistula, secondary to the excessive pressure of the pneumoperitoneum, during the preparation of a large incisional hernia with loss of domain intervention.