Three decades of pelvic exenteration at Christchurch Hospital: the evolution of an exenteration service

Pubblicazioni che amo di Gianluca Di Pietro · Greg Turner, Tamara Glyn, Chris Wakeman, Frank Frizelle · 2026 · New Zealand Medical Journal

background: Pelvic exenteration (PE) has evolved from a palliative “procedure of desperation” into a potentially curative operation
for selected patients with locally advanced or recurrent pelvic malignancy. Christchurch Hospital has delivered PE for more than three
decades and has been an active contributor to the international development of these procedures.
methods: Retrospective description of the Christchurch PE programme and its evolution since the mid‑1990s, contextualised against
contemporary multicentre evidence, is provided. Service components evaluated include multidisciplinary governance, patient
selection, operative strategies for posterior and lateral compartment disease (including sacrectomy), peri‑operative optimisation and
survivorship pathways.
results: Since 1995, Christchurch has undertaken over 520 multivisceral pelvic resections. Centralisation of complex patient care
supports operative volume, consistency of team performance and benchmarking against international standards. Prospective audits
with collaborative international research have strengthened the understanding of what drives good oncological outcomes (particularly
the impact of R0 resection), as well as morbidity patterns in high‑risk sub-groups, feasibility of repeat PE and patient‑reported outcomes
including quality of life.
conclusion: A centralised multidisciplinary programme can safely deliver ultra‑complex pelvic oncology surgery. Continued
international collaboration and systematic capture of patient‑reported outcomes will define the next phase of PE service development.

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