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The Pioneers

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Eugene M. Bricker (Columbia, USA), a contemporary of Brunschwig, had been independently performing exenterative procedures beginning in 1940 [6]. Due to adverse outcomes and the interruption of World War II, his experience remained unpublished [6]. Jesse E. Thompson (Dallas, USA), one of the founders of vascular surgery as a subspecialty, and Chester W. Howe (Boston, USA) reported the first case of “complete pelvic evisceration” for locally advanced rectal cancer (LARC) in 1950. Other early advocates of the concept included Lyon H. Appleby (Vancouver, Canada), who performed a procedure he termed a “proctocystectomy” [7], and Edgar S. Brintnall (a general and vascular surgeon) and Rubin H. Flocks (an early urologist from Iowa, USA), who termed their procedure “pelvic viscerectomy” [8].

Surgical Management of Advanced Pelvic Cancer

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