Absorbable mesh in placement of temporary implants.
OBJECTIVE
To evaluate absorbable mesh for the suturing of afterloading catheters in patients with tumors involving the chest wall.


METHODS
Patients underwent thoracotomy and resection of tumor; a layer of absorbable mesh was then sutured to the tumor bed. Nylon flexiguide afterloading catheters were sutured into the mesh at about 1.5 cm distance from each other. A second layer of mesh was then sutured on top of the catheters. The chest wall was closed. Orthogonal radiographs and CT scans of the area of implants were done to verify catheter position in each patient on day 1 and on the last day of implant. Computer dosimetry by digitization of dummy sources was performed on each set of radiographs. The same seed for both sets of films was chosen as the origin of digitization. All seed coordinates were compared directly to offset for any rotation of the patient during the two sets of films. The distances were calculated from all seed positions to the origin, then tabulated and compared.


RESULTS
The distances agreed within a few millimeters (7-8 mm). The differences may be attributed to the patient's breathing and to the localization uncertainty. The resulting dose alteration was negligible.


CONCLUSIONS
This technique appears to provide adequate anchorage of catheters with resulting constant seed position and dose distribution in areas of scant tissues or in surgical beds of considerable size.
Pisch
J
J
Department of Radiation Oncology, Beth Israel Medical Center, New York, NY 10003.
Berson
A M
AM
Harvey
J C
JC
Mishra
S
S
Beattie
E J
EJ
D000368:Aged; D001918:Brachytherapy / Q000295:instrumentation* / Q000379:methods; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D013526:Surgical Mesh; D013899:Thoracic Neoplasms / Q000532:radiotherapy*