An evaluation of the benefits and drawbacks of total pelvic exenteration in the treatment of rectal cancer
10.3760/cma.j.cn441530-20250427-00172
- VernacularTitle:直肠癌行全盆腔脏器切除术的“利”与“弊”
- Author:
Weizhong JIANG
1
;
Pan CHI
1
Author Information
1. 福建医科大学附属协和医院普通外科（结直肠外科），福州 350001
- Publication Type:Journal Article
- Keywords:
Rectal neoplasms;
Total pelvic exenteration;
Total neoadjuvant therapy;
Precision medicine;
Organ preservation
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(7):717-724
- CountryChina
- Language:Chinese
-
Abstract:
Total pelvic exenteration (TPE) is widely regarded as the most effective intervention for the management of primary locally advanced rectal cancer and locally recurrent rectal cancer. However, TPE presents several challenges, including the potential for failing to achieve R0 resection, high incidence of complication, decreased postoperative quality of life, and the possible overtreatment in patients without carcinomatous adhesions or with only inflammatory adhesions, as well as in those who achieve pathological complete response after neoadjuvant therapy. In the context of precision medicine, further investigation is necessary to enhance the accuracy of preoperative diagnoses of extrarectal cancer invasion and to explore the comprehensive application of genetic molecular typing methods alongside innovative neoadjuvant treatment strategies. Such research should aim to enhance the R0 resection rate of TPE, minimize surgical complications and mortality, improve postoperative quality of life, and achieve an optimal balance between radical resection and the preservation of organ function.
