Prevention of empty pelvis syndrome with rectus abdominis isolation of the abdominopelvic cavity and planned two-stage “stamp” skin grafting after pelvic exenteration: a case report

In recent years, pelvic exenteration has become an important approach for radical treatment of locally advanced rectal cancer or locally recurrent rectal cancer. It aims to achieve R0 resection, which means negative histological margins, by completely removing the pelvic organs and tissues invaded by the tumor, thereby improving patient survival and quality of life. However, due to the persistent presence of a large pelvic cavity, postoperative complications such as infection, effusion and hematoma, small bowel adhesion to the pelvic floor leading to intestinal obstruction, prolonged perineal wound infection, and complex fistulae are prone to occur, which is called empty pelvis syndrome. The prevention of empty pelvis syndrome is a challenge for surgeons. Our research team reports a case of rectus abdominis isolation of the abdominopelvic cavity and planned two-stage “stamp” skin grafting after pelvic exenteration to prevent empty pelvis syndrome. The outcome was satisfactory. During the 3-month follow-up after surgery, no significant signs of infection or tumor recurrence and metastasis were observed.