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Surgical Trial for Rectal Cancer Using a Tissue Expander in Association with Pelvic Partition to Prevent Radiation-Induced Bladder Dysfunction

  • A. F. M. Matin
  • Shozo Baba
  • Hiroyuki Ogiwara
Conference paper

Abstract

Postoperative pelvic radiation therapy after surgery for rectal cancer leads to serious voiding dysfunction in patients. To reduce the postoperative radiation injury, the tissue expander (TE) of 320 ml was inserted into the pelvic cavity after abdominoperineal resection of rectum, and polyglycolic acid mesh was placed at the upper region of the pelvic cavity to prevent invasion of small intestine into pelvis. Tissue expander was removed under local anesthesia 3 to 8 weeks after surgery. Comparative urodynamic study shows, residual urine volume was 70 ml or less in 10 patients treated with TE. On the other hand urinary volume in 18 patients without TE was average 215 ml (p< 0.001). Animal experiment was carried out to observe the role of free radicals after radiation therapy in urinary bladder. Free radicals was directly detected using electron spine resonance. In radiation group free radical generation increased 7 folds (p<;0.01) in compare to control. In conclusion TE minimize the side effect of radiation to bladder and preserve good bladder function, further more, free radicals are generates after radiation which may play a vital role for bladder injury.

Keywords

Rectal Cancer Abdominoperineal Resection Tissue Expander Pelvic Cavity Bladder Injury 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

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    Eickenberg H.U, Amin M, Klompus W. Urologic complications following abdominoperineal resection. J. Urol., 1976, 115: 180–182.PubMedGoogle Scholar
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    Neal D.E, Bouge R.P, Williams R.E. Histological appearances of the bladder in patients with denervation of the bladder after excision of rectum. Br.J.Urol., 1982, 54: 658–662PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1993

Authors and Affiliations

  • A. F. M. Matin
    • 1
  • Shozo Baba
    • 1
  • Hiroyuki Ogiwara
    • 1
  1. 1.Second Department of SurgeryHamamatsu University School of MedicineHamamatsu, ShizuokaJapan

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