Prevention of radiation enteritis by an absorbable polyglycolic acid mesh sling. A 60-case multicentric study.

Abstract:

: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.

journal_name

Cancer

journal_title

Cancer

authors

Rodier JF,Janser JC,Rodier D,Dauplat J,Kauffmann P,Le Bouedec G,Giraud B,Lorimier G

doi

10.1002/1097-0142(19911215)68:12<2545::aid-cncr282

subject

Has Abstract

pub_date

1991-12-15 00:00:00

pages

2545-9

issue

12

eissn

0008-543X

issn

1097-0142

journal_volume

68

pub_type

临床试验,杂志文章,多中心研究

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