Pelvic Exenteration: Surgical Approaches

Although the incidence of local recurrence after curative resection of rectal cancer has decreased due to the understand-ing of the anatomy of pelvic structures and the adoption of total mesorectal excision, local recurrence in the pelvis still re-mains a significant and troublesome complication. While surgery for recurrent rectal cancer may offer a chance for a cure, conservative management, including radiation and chemotherapy, remain widely accepted courses of treatment. Recent improvement in imaging modalities, perioperative care, and surgical techniques, including bone resection and wound coverage, have allowed for reductions in operative mortality, though postoperative morbidity still remains high. In this re-view, the techniques, including surgical approaches, employed for management of locally recurrent rectal cancer are high-lighted