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

• Published in: Reports of practical oncology and radiotherapy Vol. 17; no. 1; pp. 19 - 23
• Main Authors: Sirák, Igor, Kacerovský, Marian, Hodek, Miroslav, Petera, Jiří, Špaček, Jiří, Kašaová, Linda, Zoul, Zdeněk, Vošmik, Milan
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Urban & Partner (Poland) 01-01-2012
• Subjects: Hematology, Oncology and Palliative Medicine; Hysterectomy; Intestine; Original; Peritonealization; Radiology; Radiotherapy; Peritonealization; Hysterectomy; Radiotherapy; Intestine
• ISSN: 1507-1367; 2083-4640
• DOI: 10.1016/j.rpor.2011.10.007

Abstract 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 radiotherapy 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 volume of the small intestine within the irradiated volume and consequent late morbidity was analyzed. 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 non-peritonealization 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.