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dc.contributor.authorJoyce, M
dc.contributor.authorThirion, P
dc.contributor.authorKiernan, F
dc.contributor.authorByrnes, C
dc.contributor.authorKelly, P
dc.contributor.authorKeane, F
dc.contributor.authorNeary, P
dc.date.accessioned2012-02-01T10:49:55Z
dc.date.available2012-02-01T10:49:55Z
dc.date.issued2012-02-01T10:49:55Z
dc.identifier.citationEur J Surg Oncol. 2009 Apr;35(4):348-51. Epub 2008 Mar 21.en_GB
dc.identifier.issn1532-2157 (Electronic)en_GB
dc.identifier.issn0748-7983 (Linking)en_GB
dc.identifier.pmid18358678en_GB
dc.identifier.doi10.1016/j.ejso.2008.01.035en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207913
dc.description.abstractBACKGROUND: Radiotherapy has a significant role in the management of pelvic malignancies. However, the small intestine represents the main dose limiting organ. Invasive and non-invasive mechanical methods have been described to displace bowel out of the radiation field. We herein report a case series of laparoscopic placement of an absorbable pelvic sling in patients requiring pelvic radiotherapy. METHODS: Six patients were referred to our minimally invasive unit. Four patients required radical radiotherapy for localised prostate cancer, one was scheduled for salvage localised radiotherapy for post-prostatectomy PSA progression and one patient required adjuvant radiotherapy post-cystoprostatectomy for bladder carcinoma. All patients had excessive small intestine within the radiation fields despite the use of non-invasive displacement methods. RESULTS: All patients underwent laparoscopic mesh placement, allowing for an elevation of small bowel from the pelvis. The presence of an ileal conduit or previous surgery did not prevent mesh placement. Post-operative planning radiotherapy CT scans confirmed displacement of the small intestine allowing all patients to receive safely the planned radiotherapy in terms of both volume and radiation schedule. CONCLUSION: Laparoscopic mesh placement represents a safe and efficient procedure in patients requiring high-dose pelvic radiation, presenting with unacceptable small intestine volume in the radiation field. This procedure is also feasible in those that have undergone previous major abdominal surgery.
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshCystectomyen_GB
dc.subject.meshDisease Progressionen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIntestine, Small/radiation effectsen_GB
dc.subject.meshLaparoscopy/*methodsen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPostoperative Careen_GB
dc.subject.meshProstatectomyen_GB
dc.subject.meshProstatic Neoplasms/*radiotherapy/surgeryen_GB
dc.subject.meshRadiation Dosageen_GB
dc.subject.meshRadiation Injuries/*prevention & controlen_GB
dc.subject.meshRadiotherapy, Adjuvant/methodsen_GB
dc.subject.meshSalvage Therapy/*methodsen_GB
dc.subject.mesh*Suburethral Slingsen_GB
dc.subject.meshSurgical Meshen_GB
dc.subject.meshUrinary Bladder Neoplasms/*radiotherapy/surgeryen_GB
dc.titleLaparoscopic pelvic sling placement facilitates optimum therapeutic radiotherapy delivery in the management of pelvic malignancy.en_GB
dc.contributor.departmentDivision of Colorectal Surgery, Minimally Invasive Surgery, The Adelaide and, Meath Hospital, Tallaght, Dublin 24, Ireland. mylesjoyce@eircom.neten_GB
dc.identifier.journalEuropean journal of surgical oncology : the journal of the European Society of, Surgical Oncology and the British Association of Surgical Oncologyen_GB
dc.description.provinceLeinster
html.description.abstractBACKGROUND: Radiotherapy has a significant role in the management of pelvic malignancies. However, the small intestine represents the main dose limiting organ. Invasive and non-invasive mechanical methods have been described to displace bowel out of the radiation field. We herein report a case series of laparoscopic placement of an absorbable pelvic sling in patients requiring pelvic radiotherapy. METHODS: Six patients were referred to our minimally invasive unit. Four patients required radical radiotherapy for localised prostate cancer, one was scheduled for salvage localised radiotherapy for post-prostatectomy PSA progression and one patient required adjuvant radiotherapy post-cystoprostatectomy for bladder carcinoma. All patients had excessive small intestine within the radiation fields despite the use of non-invasive displacement methods. RESULTS: All patients underwent laparoscopic mesh placement, allowing for an elevation of small bowel from the pelvis. The presence of an ileal conduit or previous surgery did not prevent mesh placement. Post-operative planning radiotherapy CT scans confirmed displacement of the small intestine allowing all patients to receive safely the planned radiotherapy in terms of both volume and radiation schedule. CONCLUSION: Laparoscopic mesh placement represents a safe and efficient procedure in patients requiring high-dose pelvic radiation, presenting with unacceptable small intestine volume in the radiation field. This procedure is also feasible in those that have undergone previous major abdominal surgery.


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