SURGICAL REHABILITATION IN PATIENTS WITH POSTRADIATION VESICOVAGINAL FISTULAS IN CANCER OF THE CERVIX UTERI

Onkourologiâ

I. A. Fanshtein¹  E. G. Semirdzhanyants²  M. I. Nechushkin²  D. E. Avtomonov²  A. V. Petrovsky² 

[1] I. M. Sechenov First Moscow State Medical University;N. N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, Moscow;

关键词: cancer of the cervix uteri;    vesicovaginal fistulas;    radiation injuries;    bladder resection;    therapeutic effectiveness;   

DOI  :  10.17650/1726-9776-2013-9-4-66-70

来源: DOAJ

【 摘 要 】

Background. Radiotherapy is a basic treatment for patients with locally advanced cancer of the cervix uteri (CCU). However, in 20–30 % of patients, postradiation injuries result from different causes, which may give rise to fistulas.Objective: to define an optimal surgical rehabilitation method for patients with postradiation vesicovaginal fistulas in CCU.Subjects and methods. Forty-eight patients with CCU and postradiation vesicovaginal fistulas were operated on in 1996 to 2010. Patients with primary fistulas underwent 46 radical operations and 2 palliative ones; those with recurrent fistulas had 17 radical operations and 1 palliative one.Results. Recurrences after radical surgery for primary fistulas occurred in 39.1 % of the patients; the efficiency was 80.0 % for transvaginal plasty, 61.5 % for bladder resection, 61.5 % for bladder resection with ureteral reimplantation, and 0 for subtotal bladder resection. In recurrent fistulas, the efficiency was 0 for bladder resection with ureteral reimplantation, 50 % for subtotal bladder resection, and 100 % for cystectomy, Bricker surgery. Surgical rehabilitation could be achieved in a total of 40 (83.3 %) of the 48 women.Conclusion. The correct choice of surgical scope allows the satisfactory results of treatment for postradiation fistulas to be achieved in patients with CCU.

【 授权许可】

Unknown