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551 Laterally extended parametrectomy during pelvic exenteration for tumors involving the pelvic side wall
  1. Mihai Emil Capilna1,
  2. Szilard Leo Kiss1,
  3. Mihai Stanca1,
  4. Gabriela Adriana Catrinoiu1 and
  5. Dan Mihai Capilna2
  1. 1First Obstetrics and Gynecology Clinic, ‘G. E. Palade’ University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
  2. 2‘G. E. Palade’ University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania


Introduction/Background Laterally Extended Parametrectomy (LEP) was imagined as a more radical surgical procedure for the treatment of lymph node positive stage Ib and stage IIb cervical cancer. The aim of the technique was to remove the entire parametrial tissue containing lymphatic structures from the pelvic side wall. It may be also taken into consideration during pelvic exenteration, when the tumor involves the soft structures of the pelvic side wall, for a more extensive pelvic side wall dissection.

Methodology Out of the 93 pelvic exenterations performed in a tertiary university hospital between 2011 and 2023, in 9 patients a LEP was necessary for tumors involving the pelvic side wall in order to achieve surgical free margins. In all patients submitted to a pelvic exenteration, a preoperative MRI excluded external iliac vessels or bone involvement.

Results Patients’ age was between 41 and 71 (median 53.4 years old). All 9 patients had recurrences or persistent cervical cancer after definitive chemoradiation +/- initial radical surgery. Operating time range from 310 to 435 minutes. Blood loss was between 400 and 2200 mL and 4 patients necessitated intraoperative blood transfusion. No major intraoperative complications or perioperative deaths were recorded in this cohort. Postoperatively, one patient experienced a grade IIIb Dindo-Clavien complication (reoperation for small bowel fistula), and 3 grade II or I. Macroscopic lateral free margins were achieved in all 9 patients, but on the specimen, 2 patients had microscopic tumor. Regarding disease-free and overall survival, the cohort is too small to draw definitive conclusions.

Conclusion LEP might be considered as a secondary procedure during pelvic exenteration in tumors involving the lateral pelvic wall and should be part of the requested optimum training for a gynecologic oncologist surgeon.

Disclosures None.

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