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.