有几项回顾性研究表明，IV 期子宫内膜癌的最佳细胞减灭术可提高生存率 [1-3]。此外，一些研究人员报告说，对于有远处转移的子宫内膜癌，在腹腔内实现最大程度的细胞减灭术以达到明显无病的结果可以延长患者的生存期[4]。由于直肠乙状结肠在解剖学上接近女性盆腔器官，且涉及局部晚期子宫内膜癌，因此需要对子宫、附件和直肠乙状结肠进行整块切除，也称为改良后盆腔廓清术 (MPPE)以实现最佳的细胞减灭术[5,6]。此外，如果肿瘤已浸润回肠端和/或盲肠，可增加回盲肠切除术。我报告了这个需要肠道重建的手术的技术细节。我们通常在 MPPE 后放置经肛门引流管，以降低吻合口漏率和分流造口的需要 [7]。手术后未观察到可见肿瘤。无术中或术后早期并发症发生。患者术后膀胱和肠道功能没有障碍。关于手术期间子宫切除的范围，该程序按照 II 类子宫切除术的描述进行[8]。这可能部分解释了这些功能的保留。随后，她接受了6个周期的阿霉素和顺铂化疗。手术后两年，她还活着，没有复发的迹象。患者同意使用该视频。© 2025。亚洲妇科肿瘤学会、韩国妇科肿瘤学会和日本妇科肿瘤学会。

There are several retrospective studies which have suggested that optimal cytoreductive surgery for stage IV endometrial cancer improves survival [1-3]. In addition, some investigators have reported that achieving maximal cytoreduction to a visibly disease-free outcome in the abdominal cavity for endometrial cancer with distant metastases can extend patients' survival [4]. Due to the anatomic proximity of the rectosigmoid colon to the female pelvic organs and its involvement in locally advanced endometrial cancer, an en bloc resection of the uterus, adnexa, and rectosigmoid, also known as a modified posterior pelvic exenteration (MPPE), is performed to achieve optimal cytoreduction [5,6]. Additionally, if the tumor has infiltrated the ileal end and/or cecum, ileocecal resection can be added. I report the details of the technique for this surgery requiring intestinal reconstruction. We routinely placed a transanal drainage tube after a MPPE to decrease the rate of anastomotic leakage and the need for a diverting stoma [7]. No visible tumors were observed after surgery. No intraoperative or early postoperative complications occurred. The patient did not have an impediment in her postoperative bladder and bowel function. Concerning the extent of hysterectomy during surgery, the procedure was performed as described in that of a class II hysterectomy [8]. This might partly explain the preservation of these function. Subsequently, she was treated with 6 cycles of doxorubicin and cisplatin chemotherapy. Two years after surgery, she is alive with no evidence of recurrence. The patient provided informed consent for use of this video.© 2025. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.