caa a22 4500 445335017 CHVBK 20180317142751.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1245/s10434-010-1382-8 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1382-8 Radiation-Induced Bowel Complications: Laparoscopic Versus Open Staging of Gynecologic Malignancy [Elektronische Daten] [Fabio Ghezzi, Antonella Cromi, Maurizio Serati, Stefano Uccella, Giorgio Formenti, Giorgio Bogani, Paolo Vanoli] Purpose: To evaluate whether the type of surgical approach used to stage gynecologic malignancies influences the risk of developing nonrectal radiation-induced intestinal injury (NRRIII) in patients who subsequently receive adjuvant radiotherapy. Methods: A prospectively entered database was queried for all women with either primary or recurrent gynecologic malignancy who underwent external-beam radiation therapy±brachytherapy and who had prior abdominopelvic surgery at our institution. Univariate and multivariate analysis of variables potentially affecting the risk of developing significant bowel toxicity (defined as grade 2 or more according to Radiation Therapy Oncology Group scoring) were performed. Results: One hundred fifty-nine patients were identified. The site of primary tumor was the cervix in 61(38%) patients and the corpus uteri in the remaining patients (98, 62%). Treatment was delivered with a combination of external-beam and intracavitary irradiation to 50 (31.4%) patients, and 109 (68.6%) patients received only external-beam irradiation. Staging procedures were performed by open surgery in 93 (58.5%) patients, whereas laparoscopy was the surgical approach of choice in 66 (41.5%) women. Fifteen patients (9.4%) developed grade 2 or greater NRRIII, at median latency of 10months (range 3-64months); six were diagnosed as grade 3 complications requiring surgery, and three developed grade 4 complication. Multiple regression revealed an independent protective effect of pretreatment laparoscopic staging against the risk of developing both grade ≥2 and grade ≥3 NRRIII. Conclusions: Notwithstanding potential limitations of nonrandomized study design, our findings suggest that the benefits of minimal-access surgery used to perform staging procedures may translate into long-term reduction in radiation-induced bowel injury. Society of Surgical Oncology, 2010 Ghezzi Fabio Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy aut Cromi Antonella Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy aut Serati Maurizio Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy aut Uccella Stefano Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy aut Formenti Giorgio Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy aut Bogani Giorgio Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy aut Vanoli Paolo Department of Radiation Therapy, Ospedale di Circolo Macchi Foundation, Varese, Italy aut Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 782-791 1068-9265 18:3<782 2011 18 10434 https://doi.org/10.1245/s10434-010-1382-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1382-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ghezzi Fabio Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy aut NATIONALLICENCE 700 1- Cromi Antonella Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy aut NATIONALLICENCE 700 1- Serati Maurizio Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy aut NATIONALLICENCE 700 1- Uccella Stefano Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy aut NATIONALLICENCE 700 1- Formenti Giorgio Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy aut NATIONALLICENCE 700 1- Bogani Giorgio Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy aut NATIONALLICENCE 700 1- Vanoli Paolo Department of Radiation Therapy, Ospedale di Circolo Macchi Foundation, Varese, Italy aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 782-791 1068-9265 18:3<782 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer