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Total Pelvic Exenteration

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All American Operation
A coinage from Dr. Brunchwig’s pelvic surgery service at Memorial Sloan-Kettering Cancer Institution (New York City) for radical surgery of a ‘frozen pelvis’, which consists of total pelvic exenteration with en bloc resection of the bladder, urethra, rectum, anus, and supporting muscles and ligaments, together with the reproductive organs. A urinary stoma and a colostomy stoma are created to collect waste
Indications It is performed when there is no opportunity to perform a less extensive operation, because of the location and size of the cancer, e.g., stage IV cancer of the uterine cervix, urinary bladder or colorectum
total pelvic exenteration
Bruschwig procedure Gynecologic surgery A 'heroic' surgery for extensive cervical CA that persists after regional RT and/or prior total hysterectomy; because of its high M&M, TPE is reserved for biopsy-proven recurrences of tumor confined to the central pelvis, in a Pt believed capable of psychologically and physically coping with the stomas necessitated by the operation
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