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SF003/#661 Total pelvic exenteration and perineal reconstruction for recurrent cervical cancer
  1. A Thomas,
  2. R Chandy,
  3. A Sebastian,
  4. R Mittal,
  5. JK Ramireddy,
  6. R Paul Mukha,
  7. M Lamba and
  8. A Peedicayil
  1. Christian Medical College, Vellore, Gynecologic Oncology, Vellore, India


Background and Introduction Salvage procedures for recurrent and residual cervical cancer following radical chemo radiation can be offered to patients with motivation and willingness to undergo massive operative procedures. It needs the skill of a multidisciplinary team who can contribute to various aspects of this complicated procedure. Description of the technique Here we describe Total Pelvic exenteration in a 49 year old lady with residual disease of cervical cancer who after chemo radiation for a bulky stage IIIB (8 cm) endocervical adenocarcinoma of the cervix was found to have central residual disease infiltrating bladder, vagina, anal canal and rectum. She was offered total exenteration after 3 cycles of chemotherapy with Paclitaxel and Carboplatinum after ruling out metastatic disease with a PET-CT. She was operated upon by a team comprising of urologist, colorectal surgeon, gynaecologic oncologists and plastic surgeon. She underwent Total Pelvic exenteration with enbloc removal of uterus with vagina, urinary bladder, urethra, rectum and and anal canal. The ureters were diverted into an ileal conduit by Wallace technique and the colon was diverted into a Hartmans Pouch The vulval defect was reconstructed by gracilis myocutanaeous flap repair over a vicryl mesh. Post operatively her wound healed well and she was discharged on 8th post-operative day. Surgical margins were free of tumour on histopathology. She is alive and well on follow up after 30 months.

Conclusions Salvage procedures for residual and recurrent cervical cancers can result in good survival and quality of life in motivated and surgically fit patients.

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