Use of sigmoid colon for rectal substitution following pelvic exenteration

Abstract

Pelvic exenteration with rectal substitution using a mobilized segment of sigmoid colon was carried out in 11 selected patients with advanced pelvic malignancy. Satisfactory “rectal” function was achieved in six patients, eliminating the need for permanent colostomy. Rectal substitution was made possible by preserving the rectal sphincter to which the sigmoid colon segment was anastomosed. The portion of the procedure dealing with excision of the tumor and surrounding structures was not altered in patients selected for rectal substitution. With apparent increasing success in radical pelvic surgery, including decreasing operative mortality rates, efforts to increase patient acceptance by alleviating the disfigurement and disability of a permanent colostomy would seem worthwhile.