New surgical method to prevent pelvic radiation enteropathy

Journal Article · Mon Feb 01 04:00:00 EST 1988 · Am. J. Clin. Oncol.; (United States)

DOI:https://doi.org/10.1097/00000421-198802000-00007· OSTI ID:5314110

Feldman, M I; Kavanah, M T; Devereux, D F; Choe, S

Pelvic radiation doses exceeding 4000-4500 cGy are known to be associated with acute and chronic radiation enteropathy. This same radiation dose is, at the same time, only moderately effective in the elimination of microscopic malignancy, let alone gross clinical disease. Numerous medical and surgical attempts to minimize this complication have been uniformly unsuccessful. With the availability of a new synthetic, absorbable, polyglycolic acid mesh, an intestinal sling surgical procedure has been devised to exclude the small bowel from the pelvis and subsequent radiation fields. Twenty-five patients have been treated by this new technique with only one complication presenting as a fungal infection. Small-bowel barium contrast studies in 16 patients referred for postoperative radiation demonstrated 13 satisfactory exclusions of the small bowel from the translateral pelvic irradiation field. In 16 evaluable patients, three had unsatisfactory exclusion two of which were due to technical error. This has permitted high-dose (5500-6500 cGy) radiotherapy to the critical treatment volume without posttreatment complication. Mean follow-up time is 14.8 months. Several patients have been reexplored demonstrating complete absorption of the mesh without fibrinous adhesions or other foreign body reaction. It is concluded that this new technique of small bowel exclusion will permit the routine delivery of much higher doses of radiation in patients requiring improved local-regional control of their pelvic cancers and without morbidity from radiation-associated small bowel injury.

• Research Organization: Univ. Hospital Boston, MA (USA)
• OSTI ID: 5314110
• Journal Information: Am. J. Clin. Oncol.; (United States), Journal Name: Am. J. Clin. Oncol.; (United States) Vol. 11:1; ISSN AJCOD
• Country of Publication: United States
• Language: English

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560151* -- Radiation Effects on Animals-- Man
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ACUTE EXPOSURE
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BODY AREAS
CHRONIC EXPOSURE
DIGESTIVE SYSTEM
DOSES
GASTROINTESTINAL TRACT
INJURIES
INTESTINES
ORGANS
PATIENTS
PELVIS
POST-IRRADIATION EXAMINATION
RADIATION DOSES
RADIATION EFFECTS
RADIATION INJURIES
RADIATION PROTECTION
SMALL INTESTINE