Sezeur A, Martella L, Abbou C, Gallot D, Schlienger M, Vibert J F, Touboul E, Martel P, Malafosse M
Service de Chirurgie Générale, Hôpital Rothschild, Paris, France.
Am J Surg. 1999 Jul;178(1):22-5; discussion 25-6. doi: 10.1016/s0002-9610(99)00112-9.
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 away from the radiation field, and it is easily removed at the conclusion of radiotherapy.
The device was used in 22 patients: 5 retroperitoneal tumors and 17 pelvic cancers. After surgical resection of the tumor, the device is placed either in the retroperitoneal area or in the pelvic cavity. A polyglactine 910 mesh is placed between the spacer and the bowel to prevent incarceration of the loops. The prosthesis can be filled or emptied between each radiation course and finally removed by means of a short incision under local or locoregional anesthesia.
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 pelvic radiation therapy at 30, 45, and 65 Gy.
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.
已设计出一种假体，用于在癌症治疗中术后放疗时保护肠袢免受辐射。它是一个硅胶球囊，可将小肠推离辐射野，并且在放疗结束时易于取出。
该装置用于22例患者：5例腹膜后肿瘤和17例盆腔癌。肿瘤手术切除后，将该装置置于腹膜后区域或盆腔内。在间隔物与肠管之间放置聚乙醇酸910网片以防止肠袢嵌顿。假体可在每个放疗疗程之间进行充盈或排空，最后在局部或局部区域麻醉下通过短切口取出。
小肠对放疗的耐受性在每种情况下均令人满意，平均随访24.5个月（范围10至73个月）。在30、45和65 Gy的盆腔放疗期间未观察到生物学参数的改变。
当有指征时，该装置对于在成功治疗腹部、盆腔或腹膜后肿瘤的术后放疗期间预防肠损伤似乎是有效的。
