Vanneste Ben G L, van De Beek Kees, Lutgens Ludy, Lambin Philippe
Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, Netherlands.
Department of Urology, Maastricht University Medical Center+, Maastricht, Netherlands.
Int Braz J Urol. 2017 Nov-Dec;43(6):1033-1042. doi: 10.1590/S1677-5538.IBJU.2016.0494.
A rectum balloon implant (RBI) is a new device to spare rectal structures during prostate cancer radiotherapy. The theoretical advantages of a RBI are to reduce the high radiation dose to the anterior rectum wall, the possibility of a post-implant correction, and their predetermined shape with consequent predictable position.
To describe, step-by-step, our mini-invasive technique for hands-free transperineal implantation of a RBI before start of radiotherapy treatment.
We provide step-by-step instructions for optimization of the transperineal implantation procedure performed by urologists and/or radiation oncologists experienced with prostate brachytherapy and the use of the real-time bi-plane transrectal ultrasonography (TRUS) probe. A RBI was performed in 15 patients with localised prostate cancer. Perioperative side-effects were reported.
We provide 'tips and tricks' for optimizing the procedure and proper positioning of the RBI. Please watch the animation, see video in https://vimeo.com/205852376/789df4fae4. The side-effects included mild discomfort to slight pain at the perineal region in 8 out of 15 patients. Seven patients (47%) had no complaints at all. Two patients developed redness of the skin, where prompt antibiotic regimen was started with no further sequelae. One patient revealed a temporary urine retention, which resolved in a few hours following conservative treatment. Further no perioperative complications occurred.
This paper describes in detail the implantation procedure for an RBI. It is a feasible, safe and very well-tolerated procedure.
直肠球囊植入物（RBI）是一种在前列腺癌放疗期间保护直肠结构的新装置。RBI的理论优势在于减少前直肠壁的高辐射剂量、植入后进行矫正的可能性以及其预定形状和随之而来的可预测位置。
逐步描述我们在放疗开始前进行免提经会阴植入RBI的微创技术。
我们为泌尿外科医生和/或有前列腺近距离放疗经验并使用实时双平面经直肠超声（TRUS）探头的放射肿瘤学家提供经会阴植入手术优化的逐步指导。对15例局限性前列腺癌患者进行了RBI植入。报告了围手术期的副作用。
我们提供了优化手术和RBI正确定位的“技巧和窍门”。请观看动画，见https://vimeo.com/205852376/789df4fae4中的视频。副作用包括15例患者中有8例在会阴区域有轻度不适至轻微疼痛。7例患者（47%）无任何不适。2例患者出现皮肤发红，随即开始使用抗生素治疗，无进一步后遗症。1例患者出现暂时性尿潴留，保守治疗数小时后缓解。此外未发生围手术期并发症。
本文详细描述了RBI的植入手术。这是一种可行、安全且耐受性良好的手术。
