scholarly journals Postradiation genitourinary fistulae: retrospective study

2021 ◽  
Vol 14 (3) ◽  
pp. 170-174
Author(s):  
L.V. Tikhonova ◽  
◽  
G.R. Kasyan ◽  
D.Yu. Pushkar ◽  
◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Laparoscopic Approach ◽  
Long Term Results ◽  
Fistula Formation ◽  
Malignant Neoplasms ◽  
State University ◽  
Pelvic Organs ◽  
Abdominal Approach ◽  
Urogenital Fistula ◽  
Number Of Patients

Introduction. Radiation therapy of the pelvic organs, used to treat malignant neoplasms, is the main cause of urogenital fistula formation (UGF). The widespread use of radiation therapy in the treatment of malignant neoplasms of the pelvic organs has led to an increase in the number of patients with radiation injuries. The study of the prevalence, characteristics and long-term results of surgical treatment of fistulas are of great interest. Materials and methods. There are 76 patients with postradial fistulae received treatment in our Clinic Department of Urology of A.E. Evdokimov Moscow State University of Medicine and Dentistry for the last 6 years from 2012 – through 2018; 49 patients (64.5%) were operated on. The majority of the patients were suffering from vesicovaginal fistula 48.7% (37 people). Transvaginal approach was used in 35 cases (71.4%); abdominal approach was in 7 cases (14.3%); laparoscopic approach was in 3 cases (6.1%); robotic approach took place in 2 cases (4.1%); combined – one case (2%), percutaneous puncture nephrostomy – 1 case (2%). The various flaps technique took place in 40.8% of cases (20/49). Results. In total, radiation indced fistula closed in 35 out of 49 patients successfully. As a result, overall efficiency was 71%. The presented data has included our experience over the past 6 years, which is limited by the standardization of treatment and the lack of some data. Conclusions. Closing the fistula can be performed in several stages: by reducing the size of the fistula and giving patients more time to recover.

Inflammatory disease of the womans reproductive system: modern trends in diagnosis and therapy (literature review)

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 35-41
Author(s):  
T Yu Pestrikova ◽  
I V Yurasov ◽  
E A Yurasova
Keyword(s):  
Genital Tract ◽  
Inflammatory Diseases ◽  
Diagnosis And Treatment ◽  
Long Term Results ◽  
Modern Approach ◽  
Pelvic Organs ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Diagnostic Approaches

Medical, social and economic relevance of inflammatory diseases of the woman's reproductive organs requires a very careful attitude to the diagnosis and treatment of this pathology. The number of patients with genital infections and inflammatory diseases of the pelvic organs can takes the first place in structure of gynecological morbidity, and is 60.4-65.0%, and this fact is not unique to Russia, but all over the world. Incidence rate of inflammatory diseases of the pelvic organs in the first decade of the twenty-first century is increased at 1.4 times in patients who are from 18 to 24 years old and at 1.8 times in patients aged 25-29 years. At the same time, the cost of diagnosis and treatment has increased, reaching 50-60% of the total cost of providing gynecological care for population. The inflammatory diseases of pelvic organs are a collective concept. It includes of various nosological forms. There are numerous contradictions in the views on diagnostic approaches and treatment tactics, the nature of screening and control over the long-term results of treatment, the etiological and pathogenetic significance of various microorganisms found in the genital tract in patients with inflammatory diseases of the pelvic organs. Currently, there are many opinions among specialists about diagnostic approaches and treatment tactics, the type of screening and monitoring the long-term results of treatment, the etiological and pathogenetic role of various microorganisms which can be found in the genital tract in patients with inflammatory diseases. This review presents the results of a modern approach to the diagnosis, management and rehabilitation of patients with inflammatory diseases of the pelvic organs.

scholarly journals Principles of treatment of late rectal radiation damage in cancer patients

2021 ◽  
Vol 22 (1) ◽  
pp. 21-27
Author(s):  
V. V. Pasov ◽  
V. A. Korotkov ◽  
M. R. Kasymov ◽  
L. V. Aferkina ◽  
N. Р. Naumov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radiation Therapy ◽  
Radiation Damage ◽  
Malignant Neoplasms ◽  
Radiation Injuries ◽  
Pelvic Organs ◽  
Local Radiation ◽  
Rehabilitation Measures

Malignant neoplasms of the pelvic organs in the structure of cancer incidence make up about 30 % of the adult population of our country. The widespread use of radiation therapy, unfortunately, has also increased the frequency of radiation damage to the pelvic organs, which, as a rule, take a chronic course. Late radiation damage to the pelvic organs is a fairly common complication of radiation therapy for prostate cancer. According to various authors, the frequency of such iatrogenic pathological changes is up to 25 %. In fact, some patients who are cured of a malignant neoplasm acquire a new disease that significantly reduces the quality of life and requires treatment. During radiation therapy of prostate cancer, various anatomical formations can fall into the zone of radiation fields: the bladder, rectum, intra-pelvic tissue, neurovascular bundles and pelvic bones. It should be noted that isolated lesions of one organ are rare and in most cases they are combined. A special place in clinical practice is occupied by cases of local radiation injuries of the rectum, including severe complications of radiation and combined treatment associated with the formation of fistulas against the background of radiation-induced  intra-pelvic fibrosis in the absence of a relapse of the underlying disease. In addition, this situation is associated with a violation of the psycho-emotional status of patients, a sharp decrease in the quality of life, difficulties in social adaptation in society and family, pain syndrome, and problems of medical rehabilitation. Unfortunately, conservative measures for such local radiation injuries are not always effective, and the results of surgical interventions are far from ambiguous and require careful study of patients, search for an algorithm of indications and acceptable standardization of surgical manipulations.  This paper presents the basic principles of diagnosis, comprehensive treatment and rehabilitation of patients with late radiation rectitis, depending on the severity of the pathological process. Given the growth of malignant neoplasms  of the pelvic organs, we can assume a relative increase in the number of patients with complications associated with radiation therapy, which require rehabilitation measures. Such patients come to the attention of oncologists, radiologists, coloproctologists, gastroenterologists and therapists, etc. Currently, our country lacks a network of specialized regional departments that deal with this problem, as well as treatment standards, clinical recommendations, and  an algorithm for diagnostic and rehabilitation measures for local radiation injuries. In connection with the above, it became necessary to summarize the data of clinical studies based on their own experience. 

RESULTS OF TREATMENT OF LOCALLY RECURRING SOFT TISSUES SARCOMAS OF EXTREMITIES

2018 ◽  
Vol 64 (3) ◽  
pp. 408-413
Author(s):  
Grigoriy Zinovev ◽  
Georgiy Gafton ◽  
Sergey Novikov ◽  
Ivan Gafton ◽  
Yekaterina Busko ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Soft Tissues ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Tumor Location ◽  
Long Term Results ◽  
Clinical Feature ◽  
National Medical ◽  
Results Of Treatment ◽  
Kaplan Meier

Background: The most striking clinical feature of soft tissues sarcomas (STS) is their ability to recur. At present disputes about the clinical and morphological factors of STS recurrence such as the degree of malignancy, size, location, depth of tumor location, patient’s age and the presence of previous relapses in the anamnesis do not subside. It also requires clarification of the effect of the volume of tissues removed on the long-term results of treatment of STS as well as indications for the application of various regimes of remote radiation therapy. Materials and methods: Of 1802 registered cases of STS of extremities at the N.N. Petrov National Medical Research Center of Oncology from 2004 to 2016 there were selected data on 213 patients who suffered from at least one relapse of the disease. There was performed an assessment of overall, non-metastatic and disease-free survival using a single-factor (the Kaplan-Meier method) and multivariate analysis (the Cox regression model). Conclusion: The detection of various prognostic factors of locally recurrent STS allows determining the necessary treatment tactics (the vastness and traumatism of surgery and the advisability of radiation therapy).

Observed‐to‐expected incidence ratios of second malignant neoplasms after radiation therapy for medulloblastoma: A Surveillance, Epidemiology, and End Results analysis

Cancer ◽  
2021 ◽  
Author(s):  
Chonnipa Nantavithya ◽  
Arnold C. Paulino ◽  
Kaiping Liao ◽  
Kristina D. Woodhouse ◽  
Susan L. McGovern ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Malignant Neoplasms ◽  
Second Malignant Neoplasms ◽  
End Results

scholarly journals Lung autotransplantation for bronchial necrosis after radiotherapy: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuya Nobori ◽  
Masaaki Sato ◽  
Mizuki Morota ◽  
Yoshikazu Shinohara ◽  
Daisuke Yoshida ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Pulmonary Function ◽  
Treatment Success ◽  
Locally Advanced ◽  
Fistula Formation ◽  
Bronchial Anastomosis ◽  
Silicone Stent ◽  
Feasible Option ◽  
Malignant Germ Cell Tumor ◽  
The Right

Abstract Background Bronchial necrosis is a rare but fatal complication after radiation therapy. Because of the anatomical complexity and rarity of this condition, determining the most appropriate management for individual patients is extremely challenging. Lung autotransplantation is a surgical technique that has been applied to hilar neoplastic lesions to preserve pulmonary function and avoid pneumonectomy. We herein report a case of bronchial necrosis secondary to radiotherapy that was treated with lung autotransplantation. Case presentation A 46-year-old man developed broad necrosis and infection of the right bronchus secondary to previous stereotactic body-radiation therapy. This treatment was supplied close to a right hilar metastatic pulmonary tumor derived from a mediastinal malignant germ cell tumor that had been surgically resected with the left phrenic nerve. The bronchial necrosis accompanied by infection with Aspergillus fumigatus was progressive despite antibiotics and repetitive bronchoscopic debridement. Because of the patient’s critical condition and limited pulmonary function, right lung autotransplantation with preservation of the right basal segment was selected. An omental flap was placed around the bronchial anastomosis to prevent later complications. The postoperative course involved multiple complications including contralateral pneumonia and delayed wound healing at the bronchial anastomosis with resultant stenosis, the latter of which was overcome by placement of a silicone stent. The patient was discharged 5 months postoperatively. Three months after discharge, however, the patient developed hemoptysis and died of bronchopulmonary arterial fistula formation. Conclusions We experienced an extremely challenging case of bronchial necrosis secondary to radiotherapy. The condition was managed with lung autotransplantation and omental wrapping; however, the treatment success was temporary and the patient eventually died of bronchopulmonary arterial fistula formation. This technique seems to be a feasible option for locally advanced refractory bronchial necrosis, although later complications can still be fatal.

Long-term results of hepatic artery fluorodeoxyuridine and conformal radiation therapy for primary hepatobiliary cancers

1997 ◽  
Vol 37 (2) ◽  
pp. 325-330 ◽  
Author(s):  
John M. Robertson ◽  
Theodore S. Lawrence ◽  
James C. Andrews ◽  
Suzette Walker ◽  
Marc L. Kessler ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Hepatic Artery ◽  
Long Term Results ◽  
Conformal Radiation Therapy

Perioperative and long-term results after left pancreatectomy: a single-institution, non-randomized, comparative study between open and laparoscopic approach

2011 ◽  
Vol 25 (9) ◽  
pp. 2871-2878 ◽  
Author(s):  
Giovanni Butturini ◽  
Stefano Partelli ◽  
Stefano Crippa ◽  
Giuseppe Malleo ◽  
Roberto Rossini ◽  
...  
Keyword(s):  
Comparative Study ◽  
Laparoscopic Approach ◽  
Long Term Results ◽  
Single Institution ◽  
Left Pancreatectomy

The working of the urology department during the COVID-19 epidemic

2020 ◽  
Vol 10 (4) ◽  
pp. 301-307
Author(s):  
Ekaterina V. Kul’chavenya ◽  
Denis P. Kholtobin ◽  
Alexander I. Neymark
Keyword(s):  
Medical Center ◽  
Total Duration ◽  
World Health ◽  
Medical Attention ◽  
Malignant Neoplasms ◽  
City Hospital ◽  
Strict Adherence ◽  
Number Of Patients ◽  
Coronavirus Infection ◽  
Research Institute

Introduction. In March 2020, the World Health Organization declared the outbreak of the novel coronavirus infection (COVID-19) a pandemic. The pandemic also significantly affected all academic, scientific and educational activities. Material and methods. We compared the work of the urological departments of the private (Medical Center Avicenna, Novosibisk) and municipal (City Clinical Hospital No. 11, Barnaul) clinics, as well as the urogenital department of the Novosibirsk Research Institute of Tuberculosis of the Ministry of Healthcare of Russia for 6 months of calm 2019, and the first half of 2020, which coincided with the start of the COVID-19 coronavirus pandemic. Results. In March 2020, the urogenital department of the Novosibirsk Research Institute of Tuberculosis of the Ministry of Healthcare of Russia was redesigned into an observational one. In the first half of 2020, patients with malignant neoplasms, varicocele, chronic pyelonephritis, hydronephrosis, dropsy of the testicular membranes and with phimosis/paraphimosis were admitted to the urology department of the City Hospital No. 11 in Barnaul in the first half of 2020. On the contrary, statistically significant in 2020 the number of patients admitted for kidney abscess and acute prostatitis prevailed. It can be assumed that, due to the tense epidemic situation, patients postponed seeking medical attention until their condition required emergency intervention. In the Medical Center Avicenna (Novosibirsk) in the first half of 2020 the number of visits to the pediatric urologist significantly decreased, the inpatient and average bed-day decreased. On the contrary the total duration of the patients' stay in the day hospital has significantly increased, which is logically explained by the epidemic situation; there was a statistically significant decrease in the number of most operations and outpatient procedures. Conclusion. The new coronavirus infection has affected all spheres of human life, to a maximum extent on medicine. In the first six months, no unified approaches to the management of urological patients in epidemic conditions were developed; clinics worked according to internal standards. Our analysis showed that strict adherence to sanitary and hygienic standards and the implementation of anti-epidemic measures allows us to provide urological care to patients in full-even in such unfavorable conditions.

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