title: Non-closure of peritoneum after abdominal hysterectomy for uterine carcinoma does not increase late intestinal radiation morbidity.
abstract: OBJECTIVE
  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.
  
  
  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 cm(3) (range 200-840 cm(3), median 469 cm(3)); mean volume of bowels irradiated in patients without peritonealization was 456 cm(3) (range 254-869 cm(3), median 428 cm(3)). 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Oncology and Radiotherapy, University Hospital in Hradec Králové, Sokolská 581, Hradec Králové 500 05, Czech Republic.
authors.forename: Igor
authors.initials: I
authors.lastname: Sirák
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital in Hradec Králové, Sokolská 581, Hradec Králové 500 05, Czech Republic.
authors.forename: Marian
authors.initials: M
authors.lastname: Kacerovský
authors.affiliation: Department of Oncology and Radiotherapy, University Hospital in Hradec Králové, Sokolská 581, Hradec Králové 500 05, Czech Republic.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Hodek
authors.affiliation: Department of Oncology and Radiotherapy, University Hospital in Hradec Králové, Sokolská 581, Hradec Králové 500 05, Czech Republic.
authors.forename: Jiří
authors.initials: J
authors.lastname: Petera
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital in Hradec Králové, Sokolská 581, Hradec Králové 500 05, Czech Republic.
authors.forename: Jiří
authors.initials: J
authors.lastname: Spaček
authors.affiliation: Department of Oncology and Radiotherapy, University Hospital in Hradec Králové, Sokolská 581, Hradec Králové 500 05, Czech Republic.
authors.forename: Linda
authors.initials: L
authors.lastname: Kašaová
authors.affiliation: Department of Oncology and Radiotherapy, University Hospital in Hradec Králové, Sokolská 581, Hradec Králové 500 05, Czech Republic.
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Zoul
authors.affiliation: Department of Oncology and Radiotherapy, University Hospital in Hradec Králové, Sokolská 581, Hradec Králové 500 05, Czech Republic.
authors.forename: Milan
authors.initials: M
authors.lastname: Vošmik
keywords: Hysterectomy; Intestine; Peritonealization; Radiotherapy