EN MASSE "PELVIC VISCERECTOMY" WITH URETERO-INTESTINAL ANASTOMOSIS

Abstract

"PELVIC viscerectomy" is the natural outgrowth of two well founded operative procedures, cystectomy with ureterointestinal anastomosis and abdominoperineal resection of the rectum and the lower sigmoid colon. As used in this discussion, the term "pelvic viscerectomy" refers to the en masse removal of rectum, lower sigmoid colon, bladder and prostate in the male or en masse removal of the rectum, lower sigmoid colon, bladder, internal genitalia and vagina in the female. In both male and female patients, this procedure includes simultaneous en bloc excision of fatty areolar tissue and peritoneum surrounding these viscera and the regional hypogastric, external iliac, common iliac and presacral lymph nodes. There is a sizable group of patients with malignant changes limited to the pelvis that can be afforded a great deal of comfort and possibly "cure" if certain technical problems connected with the operation of pelvic viscerectomy can be overcome. Included in this group are