Use of a tissue expander to protect small bowel during radiotherapy in a cervical cancer patient with severe Crohn's disease

Ravn, Sarah; Pearcey, R.; Capstick, Valerie

doi:10.1016/j.gore.2015.08.004

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…In our experience, the breast prostheses produced several benefits especially when adjuvant radiotherapy was required and reconstruction of bowel continuity was anticipated. Even though infectious complications are common after PE , sepsis did not result in permanent loss of the prosthesis in our series. Only one case of implant removal has been reported in the literature that resulted from persistent infection .…”

Section: Discussioncontrasting

confidence: 49%

“…Although omental flaps remain one of the standard procedures employed, synthetic meshes and tissue expanders have also been increasingly used. Myocutaneous flaps provided good results but can be rather technically demanding . In our experience, the breast prostheses produced several benefits especially when adjuvant radiotherapy was required and reconstruction of bowel continuity was anticipated.…”

Section: Discussionmentioning

confidence: 82%

“…Radiation‐induced bowel injury is another major clinical problem after this surgical procedure . Different methods of pelvic floor reconstruction have been proposed in order to avoid these complications, but there is no consensus on which is the best technique . The use of breast implants to prevent bowel loops from occupying the space has seldom been described .…”

Section: Introductionmentioning

confidence: 99%

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Empty pelvis syndrome: the use of breast prosthesis in the prevention of complications

et al. 2019

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Aim Empty pelvis syndrome and radiation‐induced bowel injury are two major clinical issues resulting from the pelvic dead space after pelvic exenteration (PE). In order to avoid these complications, different methods of pelvic floor reconstruction have been proposed. We report our experience on the use of breast prosthesis. Method Fifty‐three patients who underwent PE and three who underwent palliative surgery with silicone breast prosthesis placement were included. Results Forty‐seven posterior PE, six total PE and three palliative procedures were identified. Sphincter preservation was feasible in 34 patients (62.3%). There were no deaths. Overall morbidity was 37.5%. There were no complications such as sepsis or obstruction related to the prosthesis. Adjuvant radiotherapy was delivered in 16 cases (30.1%) without any side‐effects. Reconstruction of intestinal continuity was possible in 12 patients (36.3%) with sphincter preservation and the prosthesis allowed a prompt identification of the rectal stump. Conclusion Breast prosthesis placement is a simple and safe method to minimize complications resulting from empty pelvis syndrome and can be adopted to exclude bowel loops from the radiation field. Reconstruction of intestinal continuity after resection is also simplified.

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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

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Empty pelvis syndrome: the use of breast prosthesis in the prevention of complications

et al. 2019

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Different uses of the breast implant to prevent empty pelvic complications following pelvic exenteration

2022

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Pelvic exenteration surgery is used as a standard procedure in recurrent pelvic cancers. Total pelvic exenteration (TPE) includes resection of the uterus, prostate, ureters, bladder and rectosigmoid colon from pelvic space. Empty pelvis syndrome is a complication of the TPE procedure. Following TPE, complications such as haematoma, abscess leading to permanent pus discharge and chronic infections can occur. Herein, we present the case of a man in his 50s who was referred for pelvic pain, foul-smelling discharge and non-functioning colostomy, and operated for distal rectal cancer 1.5 years ago and underwent low anterior resection. In this case, we performed TPE for the recurrent tumour. To prevent TPE complications, we used a breast implant for filling the pelvic cavity. The early and late postoperative course was uneventful.

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Very pronounced bowel sparing during radiation therapy for anal carcinoma using a natural spacer (Myoma) – a case report

Hoeng,

Exeli,

Krombach

et al. 2024

Radiat Oncol

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Background Using dose-painted intensity-modulated radiation therapy, specific dose volume constraints or implantation of tissue expanders prior to radiotherapy are validated options for reducing radiation dose on the bowel and therefore minimizing acute gastrointestinal toxicity during chemoradiation for anorectal malignancies. We describe the rare case of a female patient with a locally advanced anal carcinoma where a large myomatous uterus served as a natural spacer to protect the bowel during radiation therapy. Case presentation Initially the patient presented with anal pain, proctoscopy followed by an excisional biopsy confirmed the diagnosis of a squamous cell carcinoma of the anus. Imaging examination showed a locally advanced tumor and in addition a large uterus with typical leiomyomas up to 11.5 cm in diameter. The patient underwent chemoradiation; because of the large leiomyomas there was almost no dose burden for the small intestine and therefore practically no gastrointestinal toxicity. Conclusion As we know, this report describes the situation that a large myomatous uterus served as a natural spacer during radiation therapy in a way that is unique to date.

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Use of a tissue expander to protect small bowel during radiotherapy in a cervical cancer patient with severe Crohn's disease

Cited by 3 publications

References 9 publications

Empty pelvis syndrome: the use of breast prosthesis in the prevention of complications

Empty pelvis syndrome: the use of breast prosthesis in the prevention of complications

Different uses of the breast implant to prevent empty pelvic complications following pelvic exenteration

Very pronounced bowel sparing during radiation therapy for anal carcinoma using a natural spacer (Myoma) – a case report

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