total pelvic exenteration

to·tal pel·vic ex·en·ter·a·tion

removal of the urinary bladder, distal ureter, vagina, uterus, adnexa, rectum, anus, and adjacent lymph nodes; renders a colostomy and urinary diversion or bladder substitution necessary.
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


Alexander, U.S. surgeon, 1901-1969.
Brunschwig operation - Synonym(s): total pelvic exenteration
References in periodicals archive ?
Ileal conduits were performed for both patients as part of a total pelvic exenteration procedure.
After the diagnosis of recurrent disease, 4 patients (33%) were treated with chemotherapy and 6 patients (50%) underwent surgery including total pelvic exenteration.
8 cm Chemoradiation, Deceased carboplatin/Taxol/ Avastin, (b) debulking with HIPEC 8 Vagina, 2-mm depth RA-TLH NED invasion 9 Lungs, 5 cm Cisplatin/Taxol Deceased 10 Vagina; size not Vaginectomy, Deceased measurable vulvectomy, RT 11 Vagina, pelvic Cisplatin/Taxol Deceased sidewall;2 cm 12 Vagina, 1 cm TPE NED Abbreviations: ASC-H, atypical squamous cells, cannot rule out high-grade squamous intraepithelial lesion; ASCUS, atypical cells of undetermined significance; AWD, alive without disease; HIPEC, hyperthermic intraperitoneal chemotherapy; HPV, human papilloma virus;NED, no evidence of disease;RA-TLH, robotic-assisted total laparoscopic hysterectomy;RT, radiation therapy;SCC, squamous cell carcinoma;TPE, total pelvic exenteration.
Jimenez RE, Shoup M, Cohen AM, Paty PB, Guillem J, Wong WD: Contemporary outcomes of total pelvic exenteration in the treatment of colorectal cancer.
Russo P, Ravindran B, Katz J, Paty P, Guillem J, Cohen AM: Urinary diversion after total pelvic exenteration for rectal cancer.
Ike H, Shimada H, Ohki S, Yamaguchi S, Ichikawa Y, Fujii S: Outcome of total pelvic exenteration for locally recurrent rectal cancer.
Total pelvic exenteration for primary locally advanced and locally recurrent rectal cancer.
Domes TS, Colquhoun PH, Taylor B, Izawa JI, House AA, Luke PP: Total pelvic exenteration for rectal cancer: outcomes and prognostic factors.

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