Exenteration is a radical surgical procedure involving the removal of all organs and tissues within a specific body cavity. This typically includes the viscera, associated lymphatic structures, and often portions of the skeletal system, aiming to eradicate extensive or advanced malignancy. It's a highly invasive operation reserved for cases where less aggressive treatments have failed or are deemed insufficient. The procedure can be life-saving, offering the potential for disease control and improved quality of life in certain circumstances, despite its significant impact on bodily function and appearance, making it a last resort option. Careful patient selection, pre-operative preparation, and intensive post-operative care are crucial aspects of successful exenteration. The specific organs removed vary depending on the anatomical location of the primary cancer.
Exenteration meaning with examples
- Following the recurrence of an aggressive pelvic tumor resistant to chemotherapy and radiation, the surgical team determined that a total pelvic exenteration, including the bladder, rectum, and reproductive organs, was the only viable option to attempt tumor removal. The procedure was extensive but offered a chance for long-term survival. The patient was fully aware of the risks, including a need for a colostomy, a urostomy, and extensive recovery.
- The patient’s unrelenting perianal melanoma, with extensive regional spread, necessitated an abdominoperineal exenteration. This involved removal of the anus, rectum, sigmoid colon, and nearby lymph nodes. Due to the extent and location of the cancer this procedure was performed to ensure the patient's survival from cancer. A colostomy would be necessary. This procedure was discussed at length with the family.
- Despite multiple attempts at less invasive surgical approaches and aggressive chemotherapy regimens, the patient's extensive orbital rhabdomyosarcoma continued to progress. In a drastic measure to prevent further spread, an orbital exenteration was performed, removing the entire contents of the eye socket, including the eye itself, the surrounding soft tissues, and often portions of the bony orbit to improve overall survival.
- The patient underwent a hemipelvectomy, which is a type of pelvic exenteration, with a significant portion of the pelvic bone, the leg, and adjacent soft tissues, as the tumor had invaded the bone and surrounding structures. This complex and disfiguring procedure was the only feasible option to eliminate all visible traces of the cancerous growth, and to improve chances of patient's survival.
- Faced with a rare and rapidly growing carcinoid tumor in the thoracic cavity, the surgical team opted for a radical thoracic exenteration, involving the removal of the lung, heart, esophagus, and surrounding tissues, to remove the primary cancerous site and any suspected metastatic spread. This high-risk procedure presented the patient with major recovery challenges, but it was deemed the best course of action.