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Surgery Today
Published in: Surgery Today 4/2021

01-04-2021 | Original Article

Surgical anatomy of the pelvis for total pelvic exenteration with distal sacrectomy: a cadaveric study

Authors: Masayuki Ishii, Atsushi Shimizu, Alan Kawarai Lefor, Yasuko Noda

Published in: Surgery Today | Issue 4/2021

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Abstract

Purpose

Intraoperative bleeding from the pelvic venous structures is one of the most serious complications of total pelvic exenteration with distal sacrectomy. The purpose of this study was to investigate the topographic anatomy of these veins and the potential source of the bleeding in cadaver dissections.

Methods

We dissected seven cadavers, focusing on the veins in the surgical resection line for total pelvic exenteration with distal sacrectomy.

Results

The presacral venous plexus and the dorsal vein complex are thin-walled, plexiform, and situated on the line of resection. The internal iliac vein receives blood from the pelvic viscera and the perineal and the gluteal regions and then crosses the line of resection as a high-flow venous system. It has abundant communications with the presacral venous plexus and the dorsal vein complex.

Conclusion

The anatomical features of the presacral venous plexus, the dorsal vein complex, and the internal iliac vein make them highly potential sources of bleeding. Surgical management strategies must consider the anatomy and hemodynamics of these veins carefully to perform this procedure safely.
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Metadata
Title
Surgical anatomy of the pelvis for total pelvic exenteration with distal sacrectomy: a cadaveric study
Authors
Masayuki Ishii
Atsushi Shimizu
Alan Kawarai Lefor
Yasuko Noda
Publication date
01-04-2021
Publisher
Springer Singapore
Published in
Surgery Today / Issue 4/2021
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-020-02144-x

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