Prevention of radiation enteritis by an absorbable polyglycolic acid mesh sling. A 60-case multicentric study
✍ Scribed by Jean-Francois Rodier; Jean-Claude Janser; Denis Rodier; Jacques Dauplat; Philippe Kauffmann; Guillaume Le Bouedec; Bernard Giraud; Gerard Lorimier
- Publisher
- John Wiley and Sons
- Year
- 1991
- Tongue
- English
- Weight
- 517 KB
- Volume
- 68
- Category
- Article
- ISSN
- 0008-543X
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✦ Synopsis
Radiation-induced small bowel injury is a limiting factor to postoperative tumoricidal pelvic doses exceeding 4500 to 5000 cGy. Data from a review of the literature showed the inadequacy of medical measures and the bad reproducibility of radiation therapeutic attempts to decrease small intestine damage. Recent studies cited the benefit of a polyglycolic acid mesh to create an absorbable intestinal sling and suspend the loops above the pelvic radiation field. In 60 cases of gynecologic and rectal malignancies with a surgical intestinal morbidity of 8.3% (5 cases), the rate of radiation enteritis was 7% (4 cases) with an average follow-up of 17.8 months (range, 1 to 57 months). The quality of small intestinal elevation and the absence of loop herniation were demonstrated by the barium index. Magnetic resonance imaging was used for checking the polymer polyglycolic acid mesh position and its complete resorption at the third to fifth postoperative month. The authors conclude that this new procedure is safe in selected patients with high pelvic recurrence risk after optimal surgery, in residual disease after debulking surgery, or at the time of exploration for unresectable pelvic tumors. Clinical studies are ongoing to evaluate the long-term efficacy of this surgical technique to prevent chronic radiation enteropathy and improve locoregional control in advanced pelvic carcinomas. Cancer 68:2545-2549,1991.
ELVIC MALIGNANCIES frequently require postoper-P ative radiation therapy that may induce small bowel damage at an incidence of 5% to 25%, especially when doses exceed 4000 to 5000 c G ~. ' -~ Various surgical have been reported to prevent acute and chronic radiation These procedures are designed to protect the small bowel from the radiation beam by excluding it from the pelvic cavity.13 This aim could be achieved by using a synthetic polyglycolic acid (PGA)
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