{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T12:29:17Z","timestamp":1748262557685,"version":"3.37.3"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100018063","name":"Bowel Research UK","doi-asserted-by":"publisher","award":["SG23019"],"award-info":[{"award-number":["SG23019"]}],"id":[{"id":"10.13039\/100018063","id-type":"DOI","asserted-by":"publisher"}]},{"name":"PLANETS Cancer Charity"},{"name":"Penguins Against Cancer"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Tech Coloproctol"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Large tissue defects following pelvic exenteration (PE) fill with fluid and small bowel, leading to the empty pelvis syndrome (EPS). EPS causes a constellation of complications including pelvic sepsis and reduced quality of life. EPS remains poorly defined and cannot be objectively measured. Pathophysiology of EPS is multifactorial, with increased pelvic dead space potentially important. This study aims to describe methodology to objectively measure volumetric changes relating to EPS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The true pelvis is defined by the pelvic inlet and outlet. Within the true pelvis there is physiological pelvic dead space (PDS) between the peritoneal reflection and the inlet. This dead space is increased following PE and is defined as the exenteration pelvic dead space (EPD). EPD may be reduced with pelvic filling and the volume of filling is defined as the pelvic filling volume (PFV). PDS, EPD, and PFV were measured intraoperatively using a bladder syringe, and Archimedes\u2019 water displacement principle.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A patient undergoing total infralevator PE had a PDS of 50\u00a0ml. A rectus flap rendered the pelvic outlet watertight. EPD was then measured as 540\u00a0ml. Therefore there was a 10.8-fold increase in true pelvis dead space. An omentoplasty was placed into the EPD, displacing 130\u00a0ml; therefore, PFV as a percentage of EPD was 24.1%.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This is the first reported quantitative assessment of pathophysiological volumetric changes of pelvic dead space; these measurements may correlate to severity of EPS. PDS, EPD, and PFV should be amendable to assessment based on perioperative cross-sectional imaging, allowing for potential prediction of EPS-related outcomes.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10151-024-02952-0","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T19:21:51Z","timestamp":1719429711000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Eureka: objective assessment of the empty pelvis syndrome to measure volumetric changes in pelvic dead space following pelvic exenteration"],"prefix":"10.1007","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3602-0065","authenticated-orcid":false,"given":"C. 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Langenbecks Arch Surg 408(1):331. https:\/\/doi.org\/10.1007\/s00423-023-03069-y","journal-title":"Langenbecks Arch Surg"},{"issue":"1","key":"2952_CR2","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1111\/codi.15956","volume":"24","author":"YL Johnson","year":"2022","unstructured":"Johnson YL, West MA, Gould LE et al (2022) Empty pelvis syndrome: a systematic review of reconstruction techniques and their associated complications. Colorectal Dis 24(1):16\u201326. https:\/\/doi.org\/10.1111\/codi.15956","journal-title":"Colorectal Dis"},{"issue":"12","key":"2952_CR3","doi-asserted-by":"publisher","first-page":"1730","DOI":"10.1093\/bjs\/znad301","volume":"110","author":"PelvEx Collaborative","year":"2023","unstructured":"PelvEx Collaborative (2023) Empty pelvis syndrome: PelvEx collaborative guideline proposal. Br J Surg 110(12):1730\u20131731. https:\/\/doi.org\/10.1093\/bjs\/znad301","journal-title":"Br J Surg"},{"issue":"11","key":"2952_CR4","doi-asserted-by":"publisher","first-page":"3478","DOI":"10.3390\/cancers12113478","volume":"12","author":"JJ Tuech","year":"2020","unstructured":"Tuech JJ, Pinson J, Nouhaud FX et al (2020) Total pelvic exenteration, cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy for rectal cancer with associate peritoneal metastases: surgical strategies to optimize safety. Cancers (Basel) 12(11):3478. https:\/\/doi.org\/10.3390\/cancers12113478","journal-title":"Cancers (Basel)"},{"issue":"11","key":"2952_CR5","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1111\/codi.14737","volume":"21","author":"F Carboni","year":"2019","unstructured":"Carboni F, Federici O, Giofre M et al (2019) Empty pelvis syndrome: the use of breast prosthesis in the prevention of complications. 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This work is original and neither published, accepted, or submitted elsewhere, its publication has been approved by all co-authors. CTW is sponsored by the Fergus Scholefield Cancer Research Fund kindly donated from Penguins Against Cancer, a grant from PLANETS Cancer Charity, and Bowel Research UK (SG23019).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. Approval granted under North East \u2013 Newcastle and North 2 Research Ethics Committee (REC: 22\/NE\/0032).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The participant completed a consent form for photographs for potential publication to be taken during surgery.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}],"article-number":"74"}}