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Title:Uterine perforation - 5-year experience in 3-D image guided gynaecological brachytherapy at Institute of Oncology Ljubljana
Authors:ID Šegedin, Barbara (Author)
ID Gugić Kevo, Jasenka (Author)
ID Petrič, Primož (Author)
Files:.pdf PDF - Presentation file, download (367,57 KB)
MD5: 9FD724E4A921FE143E5241606C2C57F9
 
Language:English
Typology:1.01 - Original Scientific Article
Organization:Logo OI - Institute of Oncology
Abstract:Background. Accurate applicator placement is a precondition for the success of gynaecological brachytherapy (BT). Unrecognized uterine perforation can lead to bleeding, infection, high doses to pelvic organs and underdosage of the target volume, resulting in acute morbidity, long-term complications and reduced chance of cure. We aimed to assess the incidence and clinical characteristics of our cases with uterine perforation, review their management and impact on the treatment course. Patinets and methods. In all patients, treated with utero-vaginal image guided BT for gynaecological cancer between January 2006 and December 2011, the CT/MR images with the applicator in place were reviewed. The incidence of uterine perforations was recorded. Clinical factors that may have predisposed to increased risk of perforation were recorded. Management of perforations and their impact on treatment course was assessed. Results. 219 patients (428 applications) were suitable for analysis. Uterine perforation was found in 13 (3.0%) applications in 10 (4.6%) patients. The most frequent perforation site was posterior uterine wall (n = 9), followed by anterior wall (n = 2) and fundus (n = 2). All cases were managed conservatively, without complications. Prophylactic antibiotics were administered in 8 cases. In 4 patients, abdominal and/or transrectal ultrasound (US) guidance was used on subsequent applications for applicator insertion; adequate applicator placement was achieved and treatment completed as planned in all cases. Conclusions. 3D imaging for BT planning enables accurate identification of uterine perforations. The incidence of perforations at our department is one of the lowest reported in the literature. US guidance of applicator insertion is useful and feasible, allowing to complete the planned treatment even in challenging cases.
Keywords:uterine perforation, brachytherapy, 3D imaging, ultrasound guidance
Publication status:Published
Publication version:Version of Record
Publication date:01.06.2013
Publisher:Association of Radiology and Oncology
Year of publishing:2013
Number of pages:str. 154-160, V
Numbering:Vol. 47, no. 2
Source:Ljubljana
PID:20.500.12556/DiRROS-18539 New window
UDC:618.1
ISSN on article:1318-2099
DOI:10.2478/raon-2013-0030 New window
COBISS.SI-ID:1558651 New window
Copyright:by Authors
Publication date in DiRROS:22.03.2024
Views:256
Downloads:84
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Record is a part of a journal

Title:Radiology and oncology
Shortened title:Radiol. oncol.
Publisher:Slovenian Medical Society - Section of Radiology, Croatian Medical Association - Croatian Society of Radiology
ISSN:1318-2099
COBISS.SI-ID:32649472 New window

Secondary language

Language:Slovenian
Title:Uterine perforation
Keywords:brahiterapija, ginekologija, tridimenzionalno slikanje, rak rodil


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