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

被引:20
作者
Carboni, F. [1 ]
Federici, O. [1 ]
Giofre', M. [1 ]
Zazza, S. [1 ]
Valle, M. [1 ]
机构
[1] IRCCS Regina Elena Natl Canc Inst, Dept Digest Surg, Via Elio Chanesi 53, I-00144 Rome, Italy
关键词
pelvic exenteration; empty pelvis syndrome; radiation enteritis; breast prosthesis; reconstruction of intestinal continuity; EXENTERATION; CANCER; RADIOTHERAPY; SURGERY;
D O I
10.1111/codi.14737
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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.
引用
收藏
页码:1321 / 1325
页数:5
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