The use of a biodegradable mesh to prevent radiation-associated small-bowel injury
Journal Article
·
· Archives of Surgery (Chicago); (USA)
- Comprehensive Surgical Associates, Perth Amboy, NJ (USA)
Radiation-associated small bowel injury occurs in up to 50% of patients receiving postoperative radiotherapy following pelvic cancer surgery. We describe our experience using a biodegradable mesh that allows the small bowel to be supported above the pelvic inlet and is totally absorbed following radiation therapy. Between 1985 and 1989, 45 procedures were performed in patients with carcinoma of the rectum (anterior resection in 15 patients, abdominoperineal resection in 23 patients, pelvic exenteration in six patients, and proctocolectomy in one patient). In 30 patients a polyglycolic acid (Dexon) mesh was used, and in 15 patients a polyglactin 910 (Vicryl) mesh was used. Forty-four patients received postoperative radiotherapy. The mean (+/- SEM) dose was 56.8 +/- 18.4 Gy. There were no immediate complications related to the mesh. Follow-up ranged from 12 to 53 months (median follow-up, 34 months). With the exception of two patients who had a polyglactin 910 mesh and who developed bowel obstruction due to adhesions under the anterior abdominal wall, there has been no documented incidence of clinical radiation-associated small bowel injury. The use of the absorbable mesh may permit us to use higher doses of postoperative radiotherapy without the associated hazard of radiation-associated small bowel injury.
- OSTI ID:
- 5839063
- Journal Information:
- Archives of Surgery (Chicago); (USA), Journal Name: Archives of Surgery (Chicago); (USA) Vol. 126:3; ISSN ARSUA; ISSN 0004-0010
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
560151* -- Radiation Effects on Animals-- Man
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
DIGESTIVE SYSTEM
DISEASES
DOSES
GASTROINTESTINAL TRACT
INJURIES
INTESTINES
LARGE INTESTINE
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIATION DOSES
RADIATION EFFECTS
RADIATION INJURIES
RADIATION PROTECTION
RADIOLOGY
RADIOTHERAPY
RECTUM
SMALL INTESTINE
THERAPY
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
DIGESTIVE SYSTEM
DISEASES
DOSES
GASTROINTESTINAL TRACT
INJURIES
INTESTINES
LARGE INTESTINE
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIATION DOSES
RADIATION EFFECTS
RADIATION INJURIES
RADIATION PROTECTION
RADIOLOGY
RADIOTHERAPY
RECTUM
SMALL INTESTINE
THERAPY