Outcome and Follow-Up
Due to the complex and extensive nature of the surgery, the patient was
admitted to the Intensive Care Unit post-operatively and stayed as an
inpatient for the next 11 days before discharge. There were no
significant complications in this period.
The patient was readmitted four
weeks post surgery withsuperficial wound dehiscence and urosepsis, which
were managed with intravenous antibiotics (grade 1 Clavier Dindo
complications). She recovered well following this admission. The final
histopathology report of the removed section revealed the tumour was
matted to the bladder and the rectum, but there was no evidence of
invasion of the wall of these structures. The en-bloc specimen had clear
margins. The cavo-aortic lymph
nodes removed were normal with no evidence of metastatic carcinoma.
These findings were discussed in MDT, along with immunohistochemistry
results, and the ultimate decision was that adjuvant chemotherapy or
radiotherapy was not needed. This decision was subsequently conveyed to
the patient who had made a full recovery post-surgery. A Benchmark
imaging (CT chest, abdomen, pelvis) and MRI pelvis were performed 4
months following the total exenteration (Sep 2023) and were
unremarkable.