Minimally invasive surgery techniques in pelvic exenteration: a systematic and meta-analysis review

Surgical Endoscopy
PelvEx Collaborative

Abstract

Pelvic exenteration is potentially curative for locally advanced and recurrent pelvic cancers. Evolving technology has facilitated the use of minimally invasive surgical (MIS) techniques in selected cases. We aimed to compare outcomes between open and MIS pelvic exenteration. A review of comparative studies was performed. Firstly, we evaluated the differences in surgical techniques with respect to operative time, blood loss, and margin status. Secondly, we assessed differences in 30-day morbidity and mortality rates, and length of hospital stay. Four studies that directly compared open and MIS exenteration were included. Analysis was performed on 170 patients; 78.1% (n = 133) had open pelvic exenteration, while 21.8% (n = 37) had a MIS exenteration. The median age for open exenteration was 57.7 years versus 63 years for MIS exenteration. Even though the operative time for MIS exenteration was 83 min longer (p < 0.001), it was associated with a median of 1,750mls less blood loss. The morbidity rate for MIS exenterative group was 56.7% (n = 21/37) versus 88.5% (n = 85/96) in the open exenteration group, with pooled analysis observing a 1.17 relative risk increase in 30-day morbidity (p = 0.172) in the open exenteration group. In ...Continue Reading

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Citations

Jul 7, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·UNKNOWN PelvEx Collaborative
Jul 15, 2020·Techniques in Coloproctology·N SmithA C Lynch
Aug 19, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·S BankarA Saklani
Nov 21, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·José Tomás LarachSatish K Warrier
Jan 31, 2021·Journal of Robotic Surgery·Vandana JainSudhir Rawal
Mar 8, 2021·International Journal of Colorectal Disease·Andreas BognerChristoph Kahlert
Aug 15, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Deena HarjiQuentin Denost
Dec 3, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Isaac Seow-EnKae Jack Tay

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