Abstract：
Background: This study aims to validate the feasibility of a hub-and-spoke model for pelvic exenteration (PE) surgery while upholding favorable patient outcomes. Methods: A retrospective analysis of patients undergoing PE at our trust October 2017 and December 2023 was conducted. Descriptive statistics and Kaplan-Meier survival analysis were employed. Results: Sixty-seven patients underwent PE during the study period, mainly for locally advanced colorectal cancer (n=61, 91.04%). Minimally invasive surgery was performed in 16 cases (Robotic 3, 4.47% / Laparoscopic 13, 19.40) while the rest of patients 51 had open surgery (75.11%). Median hospital stay was 12 days (range:8-20). While 24 patients (35.82%) developed major complications (CD III-IV) post-surgery, there were no mortalities associated with pelvic exenteration in this study. Of the 67 patients undergoing surgery with curative intent, negative margins (R0 resection) were achieved in 57 patients (85.12%). This is comparable to outcomes reported by the PelvEx collaborative (85.07% versus 79.8%). At a median follow-up of 22 months, 15 patient (22.38%) recurred with 10.44% local recurrence rate. The 2 years overall and disease-free survival were 85.31% and 77.0.36%, respectively. Conclusion: Our study suggests that a nascent PE service, supported by specialist expertise and resources, can achieve good surgical outcomes within a district general hospital.
摘要：
背景：本研究旨在验证盆腔炎（PE）手术的轴辐式模型的可行性，同时维持良好的患者预后。方法：对2017年10月和2023年12月接受PE的患者进行回顾性分析。采用描述性统计和Kaplan-Meier生存分析。结果：67例患者在研究期间接受了PE，以局部晚期结直肠癌为主(n=61,91.04%)。16例进行了微创手术（Robotic3，4.47％/腹腔镜13，19.40），其余51例进行了开放手术（75.11％）。中位住院时间为12天（范围：8-20）。虽然24例患者（35.82%）在手术后出现重大并发症（CDIII-IV），在这项研究中，没有与盆腔切除术相关的死亡率。在67例接受治愈性手术的患者中，57例(85.12%)患者获得阴性切缘(R0切除)。这与PelvEx合作报告的结果相当(85.07%对79.8%)。在22个月的中位随访中，15例（22.38%）复发，局部复发率10.44%。2年总生存率和无病生存率分别为85.31%和77.0.36%,分别。结论：我们的研究表明，新生的体育服务，在专业知识和资源的支持下，在地区综合医院内可以取得良好的手术效果。
