Surgical Trial for Rectal Cancer Using a Tissue Expander in Association with Pelvic Partition to Prevent Radiation-Induced Bladder Dysfunction
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.
KeywordsRectal Cancer Abdominoperineal Resection Tissue Expander Pelvic Cavity Bladder Injury
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