Prevention of radiation enteritis in children, using a pelvic mesh sling.

Abstract:

:Between 1986 and 1991, the authors used polyglycolic acid mesh slings (placed at or above the sacral promontory) in eight children with pelvic malignancies to exclude all small bowel from the pelvis during pelvic radiation therapy. The only complications of this treatment were prolonged postoperative ileus (one patient) and temporary, partial small bowel obstruction (one patient). The average amount of radiation administered to the pelvis postoperatively was 5,349 +/- 556 cGy. In one of the eight patients, gastrointestinal symptoms (diarrhea for 24 hours) developed during radiation therapy. Early radiological evaluation confirmed that the small bowel was out of the pelvis in all five of the patients studied. Mesh disruption occurred between 2 and 5 months postoperatively (mean, 3.4 +/- 1.5 months) and was often identified symptomatically by the patient. Seven of the eight survived, with disease remission in six. Pelvic disease was absent at the time of death in the one patient who did not survive. Throughout the follow-up period (mean, 20 months) no survivor has had delayed symptoms of radiation enteritis. In children with pelvic malignancies in whom aggressive application of pelvic irradiation is required, the use of an absorbable pelvic mesh sling appears efficacious in preventing radiation-associated enteritis.

journal_name

J Pediatr Surg

authors

Meric F,Hirschl RB,Mahboubi S,Womer RB,Goldwein J,Ross AJ 3rd,Schnaufer L

doi

10.1016/0022-3468(94)90015-9

subject

Has Abstract

pub_date

1994-07-01 00:00:00

pages

917-21

issue

7

eissn

0022-3468

issn

1531-5037

pii

0022-3468(94)90015-9

journal_volume

29

pub_type

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