Laparoscopic disk excision and primary repair of the anterior rectal wall for the treatment of full-thickness bowel endometriosis

1994 ◽  
Vol 8 (6) ◽  
pp. 682-685 ◽  
Author(s):  
C. Nezhat ◽  
F. Nezhat ◽  
E. Pennington ◽  
C. H. Nezhat ◽  
W. Ambroze
2019 ◽  
Vol 100 (5) ◽  
pp. 263-269
Author(s):  
E. S. Sukhikh ◽  
I. N. Sheyno ◽  
L. G. Sukhikh ◽  
A. V. Taletskiy ◽  
A. V. Vertinskiy ◽  
...  

Objective. To determine the most effective irradiation regimen (total dose and dose per fraction) for hypofractionated treatment for prostate carcinomas according the TCP/NTCP radiobiological criteria.Material and methods. Using the tomographic information of five patients with low-risk prostate adenocarcinoma as an example, the authors devised dosimetric radiation therapy plans using the volumetric modulated arc therapy (VMAT) procedure. They considered the range of total doses of 33.5 to 38 Gy administered in 4 and 5 fractions. Based on the equivalent uniform dose concept proposed by A. Niemierko and on the computed differential dose volume histograms, the investigators modeled local tumor control probability (TCP) values, by taking into account the uncertainties of main radiobiological parameters, and estimated normal tissue complication probabilities (NTCP) for the anterior rectal wall as the organ most at risk of irradiation. An effective dosimetric plan was selected according to the UTCP criterion and the probability of complication-free tumor control, i.e. TCP (1 – NTCP).Results. The results of modeling the UTCP criterion show that with a higher total dose, the TCP value increases and so does the NTCP value, therefore the optimal radiation therapy plans are to irradiate with a total dose of 34 Gy over 4 fractions or with a dose of 36–37 Gy over 5 fractions. The difference between the fractionation regimens is that the UTCP value is achieved with a higher TCP value over 4 fractions and with a lower load on the rectal wall over 5 fractions.Conclusion. The choice of a specific fractionation regimen should be determined from the calculated values of differential dose volume histograms for each patient, as well as from radiobiological criteria, such as TCP, NTCP and UTCP.


2018 ◽  
Vol 46 (10) ◽  
pp. 4343-4349 ◽  
Author(s):  
Yong-hao You ◽  
Yi Zhang

Objective This study was performed to discuss the characteristics, diagnosis, and treatment of primary prostatic extragastrointestinal stromal tumor (EGIST). Methods The case history data of a patient with an EGIST were analyzed and discussed with a literature review. Results The patient was diagnosed with a pelvic tumor, possibly malignant. We ascertained the diagnosis by exploratory surgery and pathological biopsy. The tumor was present in the prostate and infiltrated and pressed against the anterior rectal wall. Pathological biopsy showed that the tumor comprised spindle cells, which were also present at the junction of the tumor and prostate tissue. Immunohistochemically, the tumor cells were positive for CD117, DOG-1, CD34, and smooth muscle actin and negative for S100 and desmin; Ki-67LI was about 10%. These results support the diagnosis of primary prostatic EGIST. Conclusion The rarity and nonspecific clinical manifestation of prostatic EGIST facilitate misdiagnosis. Diagnosis mainly depends on imaging examination and characteristic histopathological and immunohistochemical features, and GIST must be excluded. Surgery is the main treatment method, and imatinib is suggested for unresectable and malignant EGISTs.


2019 ◽  
Author(s):  
Steven D. Wexner ◽  
Susan M. Cera ◽  
Victoria Valinluck Lao

Rectal prolapse is a condition wherein a full thickness intussusception of the rectal wall protrudes out of the anus. The diagnosis is rare, ~ 0.5% of the population, and occurs most often in elderly females. The diagnosis is associated with constipation, fecal incontinence, or both. The repair of rectal prolapse can be divided into perineal and abdominal procedures. In this review, we will discuss preoperative evaluation, management and planning as well as describe key widely accepted perineal procedures, the Delorme and Altemeier, and report recent advances. Abdominal procedure and advances in that arena will be discussed in a separate review. This review contains 9 figures, 7 tables, and 32 references.  Key words: Rectal prolapse, perineal procedure, resection, Altemeier, Delorme, Thiersch wire, perineal stapled resection, levatoroplasty


2015 ◽  
Vol 22 (6) ◽  
pp. S139
Author(s):  
J Bae ◽  
J Choi ◽  
U Jung ◽  
W Lee ◽  
A Koh ◽  
...  

2003 ◽  
Vol 73 (8) ◽  
pp. 647-648 ◽  
Author(s):  
Rodney J. Woods ◽  
Alexander G. Heriot ◽  
Frank C. Chen

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