To evaluate the efficacy and safety of using a basement membrane biological hernia repair mesh for retroperitoneal and pelvic floor reconstruction and abdominopelvic isolation in preventing and managing post-pelvic exenteration (PE) empty pelvic syndrome.

Data were collected from 31 patients who underwent PE with retroperitoneal and pelvic floor reconstruction using a basement membrane biological hernia repair mesh at the Department of Anorectal Surgery, the Second Affiliated Hospital of Naval Medical University, between November 16, 2022, and March 27, 2024. A retrospective descriptive study was conducted to analyze the overall incidence of complications related to empty pelvic syndrome within 90 days after surgery (including small bowel obstruction, persistent deep pelvic effusion, pelvic infection with abscess or sinus tract formation), time to recovery of bowel function, time to resolution of empty pelvic syndrome, and the incidence of complications classified as Clavien-Dindo grade≥III.

Among the 31 patients, the overall incidence of complications related to empty pelvic syndrome within 90 days postoperatively was 3.2% (1/31). This single case was small bowel obstruction. Within 90 days after surgery, 3 patients died (1 died of pulmonary embolism; 2 died of tumor metastasis and disease progression). For the remaining cases, the recovery time of empty pelvic syndrome was (17.9±10.4) days, and the intestinal function recovery time was (7.7±5.6) days.

The application of a basement membrane biological hernia repair mesh in PE for retroperitoneal and pelvic floor reconstruction, as well as for isolating the abdominal and pelvic cavities, is safe and effective. The incidence of complications related to empty pelvic syndrome within 90 days after surgery is low.