For some people with advanced bowel cancers or other types of cancer that progress into the pelvis, surgery to remove multiple organs can be the only option for successful treatment. This can involve removal of the bladder, rectum, anus, womb, ovaries, parts of the pelvic bone, and pelvic floor muscles in a procedure known as pelvic exenteration.
These operations can leave behind a large empty space that can lead to complications if this area fills with fluid and other organs, such as the intestine, that are not usually found in the pelvis. If this fluid becomes infected, it can cause serious illness, leading to long-term wound problems or failure of the intestines to work normally.
This process forms a condition called empty pelvis syndrome, and nearly a third of patients having pelvic exenteration will suffer at least some problems due to it. Complications from empty pelvis syndrome can cause serious long-term health issues or even death.
Surgeons will often try to ‘fill’ the empty pelvis with tissues taken from elsewhere in the body or using biological implants. These techniques all have benefits and risks, but currently, no one knows which techniques are best to use.
New research published this month, part funded by Bowel Research UK, along with PLANETS Cancer Charity and Penguins Against Cancer, has for the first time defined empty pelvis syndrome using internationally agreed standards and started to gather data on how best to avoid its complications.
The researchers have now developed a better understanding of empty pelvis syndrome and found that using one method – biological meshes – could lead to fewer problems than other methods of pelvic filling. The team hope to confirm these findings in a larger study to make a recommendation on the best techniques.
Mr Charles West, lead researcher at the University of Southampton and Bowel Research UK grant recipient, said: “Our research is an important first step in improving treatment for patients with empty pelvis syndrome, a condition that until recently has been neglected, under-reported and undefined. These patients have usually already undergone treatment for cancer and are now undergoing one of the most significant surgeries available.
“It’s crucial we understand the impact of the different techniques to minimise complications and improve quality of life for this group of patients. If the consequences of the empty pelvis syndrome were reduced, then this surgery would become safer, and potentially more patients could benefit from these life-saving operations.”