293. Pelvic reconstruction with prosthetics in anorectal and sacral chordoma patients following aggressive pelvic floor surgery: The early results

Abstract

Aim: Aggressive surgical therapy is mostly recommended in patients with both anorectal and primary sacrococygeal cancers. Pelvic floor defects secondary to major surgery as abdominoperineal amputation, sacrectomy and multivisceral resections are really surgical challenge. Hereby, we present the early results of patients with graft reconstruction of both anterior and posterior pelvic floor defects. Patients & Results: Four male and one female oncologic patients with pelvic floor reconstruction between 2011-2013 were enrolled. The mean age and follow-up of the patients were 63 years and 15 month. Pelvic exenteration was performed for advanced rectal cancer (n1⁄42), anal cancer (n1⁄41), sacral chordoma (n1⁄42). Pelvic floor reconstruction was performed via prosthetic grafts and advanced skin flaps. Morbidity rate was 20% (n1⁄41, wound infection) and no mortality was seen. While two patients with rectal cancer had undergone neo-adjuvant therapy, the others received adjuvant therapy. Both sacrococygeal and intraabdominal recurrences were seen in one patient with sacral chordoma and debulking surgery was performed. Conclusion: Aggressive pelvic floor surgery is the mainstay in the treatment of locally advanced tumors of this origin. Pelvic gerniation due to exentration may be challenge to the surgeon and therefore wait for solution. Pelvic reconstruction with prosthetics is a good alternative with encouraging results. No conflict of interest.