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 awa y from the radiation field, and it is easily removed at the conclusion of r adiotherapy. METHODS: The device was used in 22 patients: 5 retroperitoneal tumors and 1 7 pelvic cancers. After surgical resection of the tumor, the device is plac ed either in the retroperitoneal area or in the pelvic cavity. A polyglacti ne 910 mesh is placed between the spacer and the bowel to prevent incarcera tion of the loops. The prosthesis can be filled or emptied between each rad iation 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 pe lvic radiation therapy at 30, 45, and 65 Gy. CONCLUSION: 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. Am J Surg. 1999;178:22-2 6. (C) 1999 by Excerpta Medica, Inc.