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At least 865 records · Page 48Linked to original sources
PubMed1984

[Pelvic peritonization with a polyglactin 910 mesh].

The authors, who have a long experience of polyglactin 910 mesh advocate its use for pelvic peritonization in two different situations and with two different techniques. The "lower controlled peritonization" technique aims at obtaining rapid and satisfactory healing of the peritoneum in wide resections or resections in high risk patients. The "upper controlled peritonization" technique creates a "hammock" across the upper pelvic inlet, thus protecting intestinal loops against post-operative irradiations.

Female↗
PubMed1984

Osteomyelitis pubis after radical gynecologic operations.

The clinical and microbiologic features of five cases of osteomyelitis of the pubis after radical gynecologic and exenterative pelvic surgery are reported. Pain and tenderness over the pubic symphysis and difficulty with ambulation were common features. The interval between surgery and diagnosis ranged from eight to 17 weeks (average, 13.6 weeks). Erythrocyte sedimentation rate and alkaline phosphatase level were often abnormal, and x-rays, bone scan, and gallium scan were useful diagnostic tests. Osteomyelitis of the pubis contributed to an increased hospital stay of 5.6 weeks (mean) for patients undergoing radical vulvectomy and ten to 24 weeks for patients undergoing total pelvic exenteration. Intravenous antibiotic therapy followed by long-term oral administration may provide effective therapy, but the presence of necrotic bone requires surgical excision of necrotic and infected tissue.

Adult↗
PubMed1984

Adenocarcinoma in an isolated sigmoid urinary conduit.

In recent years the colon urinary conduit has been used more frequently as an isolated urinary conduit at the time of total pelvic exenteration for recurrent carcinoma of the uterine cervix. This avoids an intestinal anastomosis and allows for the colon ureteral anastomosis to be outside of the previous irradiation field. Presented is the third case report of adenocarcinoma occurring in an isolated colonic urinary conduit, suggesting that careful surveillance for such malignancies may be required until the potential of neoplastic change is determined.

Adenocarcinoma↗
PubMed1983

Delayed vaginal reconstruction in the fibrotic pelvis following radiation or previous reconstruction.

Vaginal reconstruction was performed in 14 patients who had developed vaginal stenosis secondary to extensive pelvic fibrosis after pelvic radiation therapy (12 patients) or prior vaginal reconstruction (2 patients). Sixteen procedures were performed using a split-thickness skin graft. All patients had satisfactory vaginal restoration, and 12 patients reported good vaginal function. No fistula developed as a result of the operative procedure, but one patient later developed a rectovaginal fistula resulting from tumor recurrence. Successful vaginal reconstruction can be achieved even years after initial therapy in patients who develop an obliterated vagina from previous radiation or surgery.

Adult↗
PubMed1980

Vaginoplasty.

The historical development of vaginal reconstruction in vaginal atresia is reviewed. Two more recent indications for vaginoplasty are (i) total pelvic exenteration for carcinoma; and (ii) sex conversion in trans-sexuals. The operations available for these conditions are discussed, with particular emphasis on sex-conversion techniques. A method of vaginoplasty in inadequately treated transsexuals, using random medial thigh flaps, is presented with illustrative case reports.

Adult↗
PubMed1982

Gastrointestinal complications after radiotherapy for carcinoma of the uterine cervix.

Radiotherapy for invasive carcinoma of the uterine cervix caused gastrointestinal complications in 52 of 441 patients. External beam and intracavitary radiation together caused greater bowel damage than either method alone. Twenty-eight of the 52 patients required surgical intervention. Ileal stenosis in nine patients required primary resection with anastomosis in seven while the stenosis was bypassed in the other two. Acute perforation with peritonitis would require a diverting ileostomy and creation of a mucous fistula. A defunctioning colostomy was indicated for relief of pain, bleeding and stenosis of the rectum in 11 of 15 patients; 2 patients were treated by primary resection, 1 underwent abdominoperineal resection and another a pelvic exenteration. Of four patients with ileal and rectal involvement, one underwent right hemicolectomy and transverse colostomy, two had ileal resection and sigmoid colostomy and the other had hemicolectomy and rectal resection. All patients were well at follow-up from 3 to 120 months after operation. A Hartmann's procedure is indicated when it appears that primary closure may not succeed. Individualized management is essential.

Female↗
PubMed1980

[Management of intra-abdominal abscesses and space with pedicled omentoplasty].

The greater omentum is an organ of excellent absorption ability and or infect defence. Transposition at vascular pedicle is a simple and very useful procedure. According to our experience with 8 patients it is most suitable to fill hollow spaces for example in the liver (echinococcus cysts); it is also very useful for covering huge contaminated irradiation defects frequently occurring with pelvic exenteration.

Abdomen↗
PubMed1980

[Surgical treatment of carcinomas of the cervix stage III (author's transl)].

This study is devoted to the analysis of the surgical treatment of cancer of the uterine cervix, stage III. Three circumstances are evaluated: - Stage III with urinary disease the purpose of the surgical treatment is most often to save the renal function;--Recurrences after radiotherapy where surgery is the only possible treatment;--Stage III - Three attitudes are pointed out: Radical operation primary. Systematic surgery after preoperative radiotherapy. In the Institut Gustave-Roussy (IGR), Villejuif, exploaratory caeliotomy was performed after a preoperative irradiation of twenty Grays. The post-operative irradiation was then adapted according to the surgical evaluation.

Female↗
PubMed1980

Malignant melanoma of the vagina--report of 19 cases.

Sixteen previously unreported cases of primary vaginal melanoma were studied, 8 from the Memorial Sloan-Kettering Cancer Center (1935 to 1976) and 8 from the Connecticut Tumor Registry (1934 to 1976). In addition, 3 previously reported cases from the former institution are updated. Local control was obtained by means of primary radical surgery in 5 of 7 patients, 3 of whom are known to have subsequently died of disseminated disease. One patient initially treated with radical surgery had a local recurrence with metastasis to a regional node, but has now survived for more than 14 years following a second radical surgical procedure. Eight patients were treated primarily with radiotherapy, and 6 have died with metastatic melanoma; another died following pelvic exenteration for persistent local disease. Only 1 patient showed evidence of transient control after radiotherapy, but this patient had a local recurrence 36 months later and died with metastases. The overall 5-year survival rate for these 19 patients was 21%.

Adult↗
PubMed1993

Role of extended resection in the initial treatment of locally advanced colorectal carcinoma.

The focus of this review is the role of extended resection in the initial treatment of primary colorectal carcinoma. About 10% of patients with newly diagnosed colorectal cancer will have locally advanced disease without evident distant or discontiguous intraabdominal metastases. En bloc resection of such tumors, including attached tissues or organs, provides a 5-year survival rate of about 40%, if the microscopic margins are tumor free. As many as 60% of these large tumors are node negative; in this circumstance the 5-year survival rate approaches 70%. These results are achievable when there is a meticulous preoperative and intraoperative search for metastases, a wide anatomic resection, including en bloc lymphadenectomy, is performed, and tumor manipulation is minimized. Blunt separation of structures adherent to the primary tumor should be avoided because adhesions will be neoplastic in about 50% of cases, and cancer recurrence is virtually certain when tumor is transected. The mortality from multivisceral resection, including total pelvic exenteration, should be 10% or less. We emphasize the importance of including these patients in prospective trials to define their optimal adjuvant therapy. There is a disturbing recurring theme in published series, failure to extend the scope of resection in potentially curable patients. The management of these locally advanced lesions typically receives but cursory notice in otherwise highly detailed reviews or textbook chapters. In the present era of emerging multimodality treatment for colorectal cancer, the adequacy of the one most important treatment component--surgical resection--is seldom emphasized. Furthermore, our perusal of the recent literature disclosed no diminution in the incidence of inadequate resection, suggesting that this subject requires more emphasis in postgraduate surgical education.

Age Factors↗