Total pelvic exenteration extended to pelvic bones with subsequent VRAM flap reconstruction in patient with recurrent anal squamous cell carcinoma following chemoradiotherapy.

Autores de IIS La Fe

• Jorge Sancho Muriel

  Autor

• Pablo Guerrero Antolino

  Autor

• Hanna Barbara Cholewa

  Autor

• Blas Flor Lorente

  Autor

Grupos

• Cirugía digestiva y Cuidados perioperatorios

  

  Leader

  Matteo Frasson

Abstract

Anal squamous cell carcinoma, typically associated with human papillomavirus infection, remains a rare malignancy. This article outlines a case of local recurrence in a male patient with a history of HIV and hepatitis C virus infection, previously treated with chemoradiotherapy. Extensive tumour involvement called for total pelvic exenteration extended to anterior osteomuscular compartment and genitalia. The surgical approach involved multidisciplinary collaboration and detailed preoperative planning using three-dimensional reconstruction. Key surgical considerations comprised the following: achieving tumour-free margins (R0 resection), extensive osteotomies and intricate pelvic floor reconstruction with prosthetic mesh and flap reconstruction. The procedure successfully yielded an R0 resection, maintaining adequate lower limb functionality. Our case report underscores the benefits of pelvic exenteration in locally advanced or recurrent pelvic tumours, invariably following careful patient selection and exhaustive preoperative studies.

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Keywords

• Colon cancer; Gastrointestinal surgery; Sexual transmitted infections (viral); Surgical oncology