Novel use of an air-filled breast prosthesis to allow radiotherapy to recurrent colonic cancer.

Hdl Handle:
http://hdl.handle.net/10147/126065
Title:
Novel use of an air-filled breast prosthesis to allow radiotherapy to recurrent colonic cancer.
Authors:
O'Duffy, F; Toomey, D P; Fleming, F; McNamara, D A
Affiliation:
Department of Colorectal Surgery, Beaumont Hospital, Dublin, Ireland. fergaloduffy@hotmail.com
Citation:
Novel use of an air-filled breast prosthesis to allow radiotherapy to recurrent colonic cancer. 2011, 13 (3):e42-5 Colorectal Dis
Journal:
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
Issue Date:
Mar-2011
URI:
http://hdl.handle.net/10147/126065
DOI:
10.1111/j.1463-1318.2010.02476.x
PubMed ID:
21320268
Abstract:
AiM: The authors present the novel and successful use of an air-filled breast prosthesis for extra pelvic exclusion of small bowel to facilitate adjuvant radiotherapy following resection of recurrent adenocarcinoma of the ascending bowel. The therapeutic use of radiotherapy in colon cancer can cause acute or chronic radiation enteropathy. Mobile small bowel can be sequestered in 'dead space' or by adhesions exposing it to adjuvant radiotherapy. A variety of pelvic partitioning methods have been described to exclude bowel from radiation fields using both native and prosthetic materials.; In this case a 68 year old presented with ascending colon adenocarcinoma invading the peritoneum and underwent en bloc peritoneal resection. Thirty-seven months later surveillance CT identified a local recurrence. Subsequent resection resulted in a large iliacus muscle defect which would sequester small bowel loops thus exposing the patient to radiation enteropathy. The lateral position of the defect precluded the use of traditional pelvic partitioning methods which would be unlikely to remain in place long enough to allow radiotherapy. A lightweight air-filled breast prosthesis (Allergan 133 FV 750 cms) secured in place with an omentoplasty was used to fill the defect.; Following well tolerated radiotherapy the prosthesis was deflated under ultrasound guidance and removed via a 7-cm transverse incision above the right iliac crest. The patient is disease free 18 months later with no evidence of treatment related morbidity.; The use of a malleable air-filled prosthesis for pelvic partitioning allows specific tailoring of the prosthesis size and shape for individual patient defects. It is also lightweight enough to be secured in place using an omentoplasty to prevent movement related prosthesis migration. In the absence of adequate omentum a mesh sling may be considered to allow fixation. In this case the anatomy of the prosthesis position allowed for its removal without the need for repeat laparotomy. Pre-operative deflation of the air-filled prosthesis under ultrasound guidance also reduces the size of the incision required for removal. This technique may be valuable to prevent collateral small bowel irradiation following resection of renal or retroperitoneal malignancy.
Item Type:
Article
Language:
en
ISSN:
1463-1318

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Duffy, Fen
dc.contributor.authorToomey, D Pen
dc.contributor.authorFleming, Fen
dc.contributor.authorMcNamara, D Aen
dc.date.accessioned2011-03-29T13:19:51Z-
dc.date.available2011-03-29T13:19:51Z-
dc.date.issued2011-03-
dc.identifier.citationNovel use of an air-filled breast prosthesis to allow radiotherapy to recurrent colonic cancer. 2011, 13 (3):e42-5 Colorectal Disen
dc.identifier.issn1463-1318-
dc.identifier.pmid21320268-
dc.identifier.doi10.1111/j.1463-1318.2010.02476.x-
dc.identifier.urihttp://hdl.handle.net/10147/126065-
dc.description.abstractAiM: The authors present the novel and successful use of an air-filled breast prosthesis for extra pelvic exclusion of small bowel to facilitate adjuvant radiotherapy following resection of recurrent adenocarcinoma of the ascending bowel. The therapeutic use of radiotherapy in colon cancer can cause acute or chronic radiation enteropathy. Mobile small bowel can be sequestered in 'dead space' or by adhesions exposing it to adjuvant radiotherapy. A variety of pelvic partitioning methods have been described to exclude bowel from radiation fields using both native and prosthetic materials.-
dc.description.abstractIn this case a 68 year old presented with ascending colon adenocarcinoma invading the peritoneum and underwent en bloc peritoneal resection. Thirty-seven months later surveillance CT identified a local recurrence. Subsequent resection resulted in a large iliacus muscle defect which would sequester small bowel loops thus exposing the patient to radiation enteropathy. The lateral position of the defect precluded the use of traditional pelvic partitioning methods which would be unlikely to remain in place long enough to allow radiotherapy. A lightweight air-filled breast prosthesis (Allergan 133 FV 750 cms) secured in place with an omentoplasty was used to fill the defect.-
dc.description.abstractFollowing well tolerated radiotherapy the prosthesis was deflated under ultrasound guidance and removed via a 7-cm transverse incision above the right iliac crest. The patient is disease free 18 months later with no evidence of treatment related morbidity.-
dc.description.abstractThe use of a malleable air-filled prosthesis for pelvic partitioning allows specific tailoring of the prosthesis size and shape for individual patient defects. It is also lightweight enough to be secured in place using an omentoplasty to prevent movement related prosthesis migration. In the absence of adequate omentum a mesh sling may be considered to allow fixation. In this case the anatomy of the prosthesis position allowed for its removal without the need for repeat laparotomy. Pre-operative deflation of the air-filled prosthesis under ultrasound guidance also reduces the size of the incision required for removal. This technique may be valuable to prevent collateral small bowel irradiation following resection of renal or retroperitoneal malignancy.-
dc.language.isoenen
dc.titleNovel use of an air-filled breast prosthesis to allow radiotherapy to recurrent colonic cancer.en
dc.typeArticleen
dc.contributor.departmentDepartment of Colorectal Surgery, Beaumont Hospital, Dublin, Ireland. fergaloduffy@hotmail.comen
dc.identifier.journalColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Irelanden
dc.description.provinceLeinster-

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