Small intestine protection from radiation by means of a removable adapted prosthesis.
BACKGROUND
A prosthesis has been designed to protect intestinal loops from radiation when postsurgical radiotherapy is necessary in cancer treatment. It is a silicone balloon that allows the small bowel to be pushed back away from the radiation field, and it is easily removed at the conclusion of radiotherapy.


METHODS
The device was used in 22 patients: 5 retroperitoneal tumors and 17 pelvic cancers. After surgical resection of the tumor, the device is placed either in the retroperitoneal area or in the pelvic cavity. A polyglactine 910 mesh is placed between the spacer and the bowel to prevent incarceration of the loops. The prosthesis can be filled or emptied between each radiation course and finally removed by means of a short incision under local or locoregional anesthesia.


RESULTS
The tolerance of the small intestine to radiation therapy has been satisfactory in each case, with a mean follow-up of 24.5 months (range 10 to 73). No modification of biological parameters was observed during the pelvic radiation therapy at 30, 45, and 65 Gy.


CONCLUSIONS
This device should appears to efficient for prevention of bowel injury during postsurgical radiation in successful treatment of abdominal, pelvic, or retroperitoneal tumors when indicated.
Sezeur
A
A
Service de Chirurgie Générale, Hôpital Rothschild, Paris, France.
Martella
L
L
Abbou
C
C
Gallot
D
D
Schlienger
M
M
Vibert
J F
JF
Touboul
E
E
Martel
P
P
Malafosse
M
M
D000008:Abdominal Neoplasms / Q000532:radiotherapy*; D006801:Humans; D007421:Intestine, Small / Q000528:radiation effects*; D010386:Pelvic Neoplasms / Q000532:radiotherapy*; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*