Novel use of the Bakri balloon to minimize empty pelvis syndrome following laparoscopic total pelvic exenteration
| Autor: | Jitender Rohila, Diwakar Pandey, Vivek Sukumar, Sanket Bankar, Ashwin Desouza, Avanish Saklani, Vaishali Paliwal, Jayesh Gori |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Variable time Locally advanced Pelvic inlet Pelvis 03 medical and health sciences 0302 clinical medicine medicine Rectal Adenocarcinoma Humans Prospective Studies Prospective cohort study Bakri balloon Pelvic exenteration Rectal Neoplasms business.industry Gastroenterology PELVIS syndrome medicine.disease Pelvic Exenteration Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Laparoscopy 030211 gastroenterology & hepatology business |
| Zdroj: | Colorectal Disease. 22:2322-2325 |
| ISSN: | 1463-1318 1462-8910 |
| Popis: | Aim Pelvic exenteration is the only surgical option for locally advanced pelvic malignancies infiltrating the surrounding organs. The resultant pelvic void after the procedure is responsible for a number of complications, collectively termed empty pelvis syndrome (EPS). We aim to show how EPS can be minimized by presenting a case series demonstrating the surgical technique of laparoscopic total pelvic exenteration with bilateral pelvic node dissection along with a novel use of the Bakri balloon. Method This is a case series of three successive patients undergoing laparoscopic total pelvic exenteration for locally advanced primary, nonmetastatic rectal adenocarcinoma over a period of 1 month in a specialized colorectal unit at a tertiary cancer centre. The Bakri balloon was deployed in all three patients and retained for variable time intervals postoperatively. Features of EPS were prospectively documented. Results In the first patient, the Bakri balloon was completely deflated and removed on postoperative day (POD) 5. The patient developed subacute intestinal obstruction which resolved with conservative management by POD 12. In the second and third patients, the Bakri balloon was deflated in a sequential manner, beginning on POD 8, until it was finally removed on POD 11. Neither of these patients had any abdominal complaints. A postoperative CT scan of both these patients showed the small bowel loops clearly above the pelvic inlet. Conclusions The Bakri balloon is a simple, safe and cost-effective method to reduce the complications of EPS following laparoscopic total pelvic exenteration. A prospective study is ongoing to objectively quantify the benefits of this technique. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text