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Volume 17, Number 1, 2012

Non-closure of peritoneum after abdominal hysterectomy for uterine carcinoma does not increase late intestinal radiation morbidity

Igor Sirák, Marian Kacerovský, Miroslav Hodek, Jiri Petera, Jiri Špaček, Linda Kašaová, Zdenek Zoul, Milan Vošmik


Background/Aim: To evaluate whether non-closure of the visceral peritoneum after total
abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO) in patients with
uterine corpus carcinoma influences the volume of the small intestine within the irradiated
volume during adjuvant radiotherapy or late radiation intestinal toxicity.
Materials and methods: A total of 152 patients after TAH + BSO with adjuvant pelvic radio-
therapy were studied. The state of peritonealization was retrospectively evaluated based on
surgical protocols. The volume of irradiated bowels was calculated by CT-based delineation
in a radiotherapy planning system. The influence of visceral peritonealization upon the vol-
ume of the small intestine within the irradiated volume and consequent late morbidity was
Results: Visceral peritonealization was not performed in 70 (46%) of 152 studied patients.
The state of peritonealization did not affect the volume of the irradiated small intestine
(p = 0.14). Mean volume of bowels irradiated in patients with peritonealization was 488 cm3
(range 200–840 cm3, median 469 cm3); mean volume of bowels irradiated in patients without
peritonealization was 456 cm3 (range 254–869 cm3, median 428 cm3). We did not prove
any significant difference between both arms. Nor did we observe any influence of nonperitonealization upon late intestinal morbidity (p = 0.34).
Conclusion: Non-closure of the visceral peritoneum after hysterectomy for uterine corpus
carcinoma does not increase the volume of the small intestine within the irradiated volume,
with no consequent intestinal morbidity enhancement.

Signature: Rep Pract Oncol Radiother, 2012; 17(1) : 19-23

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