AIM:To analyze the major complications after exentera-tion of gynecological and rectal malignancies.METHODS:Twenty-two patients with gynecologicalmalignancy and 6 with rectal malignancy underwentpelvic exenteration(PE)between 1996 and 2005.PE wasperformed for primary malignancy in 71.4% of cases(vulvar cancer in 13,cancer rectal in 5,cervical cancerin 1 and Bartholin’s gland cancer in 1 cases respectivelyand recurrent malignancy in 28.6% of cases(cervicalcancer in 5,ovarian cancer in 1,uterine sarcoma in 1and rectal cancer in 1 cases respectively).Posterior PE,total PE and anterior PE were most often performed.RESULTS:Major complications in the operative fieldinvolving the urinary tract infection or the wounddehiscence occurred in 12 patients(42.9%).Earlycomplications included massive bleeding from the sacralplexus,adult respiratory distress syndrome(ARDS),thrombophlebitis,acute renal failure,urinary bladderdysfunction,ureter damage,re-operation and pulmonaryembolus.Urinary incontinence was observed in 2 womenas a late complication.In 1 patient a nephrostomy wasperformed in 1 patient due to extensive hydronephrosisand 1 patient had complications connected with thegastrointestinal tract.The mortality rate was 7%,ofwhich inter-operative mortality accounted for 3.5%.Major complications often occurred in advancedprimary vulvar cancer affecting those with recurrentmalignancies.CONCLUSION:PE is more beneficial to patientswith primary vulvar and rectal cancer than to thosewith recurrent cancer.Knowledge of the inherentcomplications and morbidity of PE is essential. AIM:To analyze the major complications after exentera-tion of gynecological and rectal malignancies.METHODS:Twenty-two patients with gynecologicalmalignancy and 6 with rectal malignancy underwentpelvic exenteration(PE)between 1996 and 2005.PE wasperformed for primary malignancy in 71.4% of cases (vulvar cancer in 13, cancer rectal in 5, cervical cancerin 1 and Bartholin’s gland cancer in 1 cases respectivelyand recurrent malignancy in 28.6% of cases(cercericalcancer in 5,ovarian cancer in 1,uterine sarcoma in 1and rectal cancer in 1 cases respectively) .Posterior PE, total PE and anterior PE were most often performed.RESULTS: Major complications in the operative field involving the urinary tract infection or the wounddehiscence occurred in 12 patients(42.9%).Early complications included massive injury from the sacralplexus,adult respiratory distress syndrome (ARDS), thrombophlebitis, acute renal failure, urinary bladderdysfunction, ureter damage, re-operation and pulmonaryembolus.Urinary incontinenc e was observed in 2 womenas a late complication.In 1 patient a nephrostomy wasperformed in 1 patient due to extensive hydronephrosisand 1 patient had complications connected with the gastrointestinal.tract mortality rate was 7%, ofwhich inter-operative mortality accounted for 3.5%.Major Complications often occurred in advancedprimary vulvar cancer affecting those with recurrentmalignancies.CONCLUSION:PE is more beneficial to patientswith primary vulvar and rectal cancer than to thosewith recurrent cancer.Knowledge of the inherentcomplications and morbidity of PE is essential.