Skip to main content
Erschienen in: Pediatric Surgery International 9/2005

01.09.2005 | Case Report

Use of a tissue expander and a polyglactic acid (Vicryl) mesh to reduce radiation enteritis: case report and literature review

verfasst von: A. Abhyankar, M. Jenney, S. N. Huddart, D. W. O. Tilsley, R. Cox, M. Saad

Erschienen in: Pediatric Surgery International | Ausgabe 9/2005

Einloggen, um Zugang zu erhalten

Abstract

Management of stage IV rhabdomyosarcoma comprises systemic chemotherapy with local control by conservative surgery and radiotherapy. Abdominal radiotherapy may lead to radiation enteritis causing such serious morbidity as malabsorption, fistulae or stricture formation. The risk increases with the dose of radiation and length of bowel involved. Various methods have been utilised to displace the bowel from the radiation field. Usually these are applied in patients requiring pelvic irradiation. We report a case of metastatic alveolar rhabdomyosarcoma requiring radiotherapy to the right renal bed. Effective displacement of small bowel from the tumour site was achieved by a combined use of a tissue expander and Vicryl mesh. There were no complications from the surgery. This is the first report discussing combined use of a tissue expander and Vicryl mesh to aid radiotherapy to the renal fossa in a paediatric patient.
Literatur
1.
Zurück zum Zitat Galland RB, Spencer J (1987) Natural History and surgical management of radiation enteritis. Br J Surg 74:742–747PubMedCrossRef Galland RB, Spencer J (1987) Natural History and surgical management of radiation enteritis. Br J Surg 74:742–747PubMedCrossRef
2.
Zurück zum Zitat Touboul E, Balosso J, Schlienger M, Laugier A (1996) Radiation injury of the small intestine. Radiobiological, radiopathological aspects; risk factors and prevention. Ann Chir 50(1):58–71PubMed Touboul E, Balosso J, Schlienger M, Laugier A (1996) Radiation injury of the small intestine. Radiobiological, radiopathological aspects; risk factors and prevention. Ann Chir 50(1):58–71PubMed
3.
Zurück zum Zitat Letschert JG, Lebesque JV, Aleman BM et al (1994) The volume effect in radiation-related late small bowel complications: results of a clinical study of the EORTC radiotherapy Cooperative Group in patients treated for rectal carcinoma. Radiotherapy Oncol 32(2):116–123CrossRef Letschert JG, Lebesque JV, Aleman BM et al (1994) The volume effect in radiation-related late small bowel complications: results of a clinical study of the EORTC radiotherapy Cooperative Group in patients treated for rectal carcinoma. Radiotherapy Oncol 32(2):116–123CrossRef
4.
Zurück zum Zitat Rubio CA, Jalnas M (1996) Dose-time-dependent histological changes following irradiation of the small intestine of rats. Dig Dis Sci 41(2):392–401CrossRefPubMed Rubio CA, Jalnas M (1996) Dose-time-dependent histological changes following irradiation of the small intestine of rats. Dig Dis Sci 41(2):392–401CrossRefPubMed
5.
Zurück zum Zitat Shanahan TG, Mehta MP, Bertelrud KL et al (1990) Minimization of small bowel volume within treatment fields utilizing customized “belly boards”. Int J Radiat Oncol Biol Phys 19(2):469–476PubMed Shanahan TG, Mehta MP, Bertelrud KL et al (1990) Minimization of small bowel volume within treatment fields utilizing customized “belly boards”. Int J Radiat Oncol Biol Phys 19(2):469–476PubMed
6.
Zurück zum Zitat Hindley A, Cole H (1993) Peritoneal insufflation to displace the small bowel during pelvic and abdominal radiotherapy in carcinoma of cervix. Br J Radiol 66(781):667–673PubMedCrossRef Hindley A, Cole H (1993) Peritoneal insufflation to displace the small bowel during pelvic and abdominal radiotherapy in carcinoma of cervix. Br J Radiol 66(781):667–673PubMedCrossRef
7.
Zurück zum Zitat Gallagher MJ, Bereton HD, Rostock RA et al (1989) A prospective study of treatment techniques to minimise the volume of pelvic small bowel with reduction of acute and late effects associated with pelvic irradiation. Int J Radiat Oncol Biol Phys 12:1565–1573 Gallagher MJ, Bereton HD, Rostock RA et al (1989) A prospective study of treatment techniques to minimise the volume of pelvic small bowel with reduction of acute and late effects associated with pelvic irradiation. Int J Radiat Oncol Biol Phys 12:1565–1573
8.
Zurück zum Zitat Vasilev SA, McGonigle KF, Spencer-Smith EL (1995) Intestinal peritoneal sling as an adjunct to radical pelvic operation and pelvic irradiation. J Am Coll Surg 180(5):568–572PubMed Vasilev SA, McGonigle KF, Spencer-Smith EL (1995) Intestinal peritoneal sling as an adjunct to radical pelvic operation and pelvic irradiation. J Am Coll Surg 180(5):568–572PubMed
9.
Zurück zum Zitat Rodier JF, Janser JC, Roy C, Rodier D (1989) Pelvic exclusion using polyglactin 910 mesh (Vicryl) for preventing radiation injuries of the small intestine Apropos of a series of 24 cases. Bull Cancer 76(10):1121–1125PubMed Rodier JF, Janser JC, Roy C, Rodier D (1989) Pelvic exclusion using polyglactin 910 mesh (Vicryl) for preventing radiation injuries of the small intestine Apropos of a series of 24 cases. Bull Cancer 76(10):1121–1125PubMed
10.
Zurück zum Zitat Evans DB, Shumate CR, Ames FC, Rich TA (1991) Use of Dexon Mesh for abdominal partitioning above the peritoneal reflection. Dis Colon Rectum 34(9):833–835CrossRefPubMed Evans DB, Shumate CR, Ames FC, Rich TA (1991) Use of Dexon Mesh for abdominal partitioning above the peritoneal reflection. Dis Colon Rectum 34(9):833–835CrossRefPubMed
11.
Zurück zum Zitat Chen JS, Chang Chien CR, Wang JY et al (1992) Pelvic peritoneal reconstruction to prevent radiation enteritis in rectal carcinoma. Dis Colon Rectum 35(9):897–901CrossRefPubMed Chen JS, Chang Chien CR, Wang JY et al (1992) Pelvic peritoneal reconstruction to prevent radiation enteritis in rectal carcinoma. Dis Colon Rectum 35(9):897–901CrossRefPubMed
12.
Zurück zum Zitat Sugarbaker PH (1983) Intrapelvic prosthesis to prevent injury of the small intestine with high dosage pelvic irradiation. Surg Gynaecol Obstet 157:269–271 Sugarbaker PH (1983) Intrapelvic prosthesis to prevent injury of the small intestine with high dosage pelvic irradiation. Surg Gynaecol Obstet 157:269–271
13.
Zurück zum Zitat Burnett AF, Coe FL, Klement V, O’Meara AT et al (2000) The use of a pelvic displacement prosthesis to exclude the small intestine from the radiation field following radical hysterectomy. Gynecol Oncol 79(3):438–43CrossRefPubMed Burnett AF, Coe FL, Klement V, O’Meara AT et al (2000) The use of a pelvic displacement prosthesis to exclude the small intestine from the radiation field following radical hysterectomy. Gynecol Oncol 79(3):438–43CrossRefPubMed
14.
Zurück zum Zitat Hong A, Stevens G, Stephen M (2000) Protection of the small bowel during abdominal radiation therapy with a tissue expander. Aust N Z J Surg 70:690–692CrossRefPubMed Hong A, Stevens G, Stephen M (2000) Protection of the small bowel during abdominal radiation therapy with a tissue expander. Aust N Z J Surg 70:690–692CrossRefPubMed
15.
Zurück zum Zitat Hoffman JP, Lanuano R, Carp NZ et al (1994) Morbidity after intraperitoneal insertion of saline filled tissue expanders for small bowel exclusion from radiotherapy fields: a prospective four-year experience with 34 patients. Am Surg 60(7):473–482PubMed Hoffman JP, Lanuano R, Carp NZ et al (1994) Morbidity after intraperitoneal insertion of saline filled tissue expanders for small bowel exclusion from radiotherapy fields: a prospective four-year experience with 34 patients. Am Surg 60(7):473–482PubMed
Metadaten
Titel
Use of a tissue expander and a polyglactic acid (Vicryl) mesh to reduce radiation enteritis: case report and literature review
verfasst von
A. Abhyankar
M. Jenney
S. N. Huddart
D. W. O. Tilsley
R. Cox
M. Saad
Publikationsdatum
01.09.2005
Verlag
Springer-Verlag
Erschienen in
Pediatric Surgery International / Ausgabe 9/2005
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-005-1490-x

Weitere Artikel der Ausgabe 9/2005

Pediatric Surgery International 9/2005 Zur Ausgabe

ADHS-Medikation erhöht das kardiovaskuläre Risiko

16.05.2024 Herzinsuffizienz Nachrichten

Erwachsene, die Medikamente gegen das Aufmerksamkeitsdefizit-Hyperaktivitätssyndrom einnehmen, laufen offenbar erhöhte Gefahr, an Herzschwäche zu erkranken oder einen Schlaganfall zu erleiden. Es scheint eine Dosis-Wirkungs-Beziehung zu bestehen.

Erstmanifestation eines Diabetes-Typ-1 bei Kindern: Ein Notfall!

16.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Manifestiert sich ein Typ-1-Diabetes bei Kindern, ist das ein Notfall – ebenso wie eine diabetische Ketoazidose. Die Grundsäulen der Therapie bestehen aus Rehydratation, Insulin und Kaliumgabe. Insulin ist das Medikament der Wahl zur Behandlung der Ketoazidose.

Frühe Hypertonie erhöht späteres kardiovaskuläres Risiko

Wie wichtig es ist, pädiatrische Patienten auf Bluthochdruck zu screenen, zeigt eine kanadische Studie: Hypertone Druckwerte in Kindheit und Jugend steigern das Risiko für spätere kardiovaskuläre Komplikationen.

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

16.05.2024 Pädiatrische Allergologie Nachrichten

Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.