Total Pelvic Exenteration surgery - Considerations for healthcare professionals

Eur J Surg Oncol. 2023 Jan;49(1):225-236. doi: 10.1016/j.ejso.2022.08.011. Epub 2022 Aug 18.

Abstract

Background: Associated with considerable risk of morbidity, Total Pelvic Exenteration (TPE) is a life-altering procedure involving a significant prolonged recovery. As a result, and with the view of achieving the best outcomes and lessen short and long-term morbidities, a well-thought-out and coordinated multidisciplinary team approach, is crucial to the provision of safe and high-quality care.

Method: Using a nominal group technique and qualitative methodology, this article explores the current practices in the care of oncology patients who undergo TPE surgery, in a tertiary cancer centre, by highlighting considerations of a collaboratively multi-disciplinary team.

Results: This article provides guidance on the multi-disciplinary team approach, relating to TPE surgery, with discussion of clinical concerns, and with the goal of high patient satisfaction, provision of effective care and the lessening of short and long-term morbidities.

Conclusion: Oncology patients that undergo TPE surgery benefit from the contribution of a diversified multidisciplinary team as skilled and competent care that meets patient's health and social care needs is provided in a holistic, comprehensive, and timely care manner. Improving patient's care, pathway and postoperative outcomes, with the use of clinical expertise and support from professionals in the multidisciplinary team, can maximise care.

Keywords: Colorectal cancer; Colorectal surgery; Exenteration; Pelvic exenteration; Rectal cancer.

MeSH terms

  • Colorectal Neoplasms* / surgery
  • Delivery of Health Care
  • Humans
  • Morbidity
  • Neoplasm Recurrence, Local / surgery
  • Pelvic Exenteration* / methods
  • Postoperative Complications / epidemiology
  • Postoperative Complications / surgery
  • Rectal Neoplasms* / surgery