Protection of the small bowel with a silicone tissue expander prosthesis and a polyglycolic acid mesh during radiation therapy for cervical carcinoma

Use of a tissue expander to protect small bowel during radiotherapy in a cervical cancer patient with severe Crohn's disease

“…However, radiation cystitis and proctitis remain common, as the TE does not protect the urinary bladder, ureters, or rectum. In addition, the TE exerts a mass effect on surrounding structures (colon, ureters, urinary bladder, iliac vessels), which may lead to thromboembolism ( Burnett et al, 2000 ), a sensation of heaviness ( Sezeur et al, 1999 ), hydronephrosis and constipation ( Delaloye et al, 1994 ). These risks increase with the size of the TE ( McKay et al, 2011 ).…”

“…We elected to place both a tissue expander with a Vicryl mesh hammock because of reports of TE migration and loops of the small bowel slipping down into the radiation field ( Geller et al, 2009 ). Several studies ( Sezeur et al, 1999 , Delaloye et al, 1994 ) have described the concomitant use of a Vicryl mesh hammock with a TE. Of eighteen patients described by Delaloye et al ( Delaloye et al, 1994 ), one experienced constipation and the other transient bilateral hydronephrosis.…”

“…Several studies ( Sezeur et al, 1999 , Delaloye et al, 1994 ) have described the concomitant use of a Vicryl mesh hammock with a TE. Of eighteen patients described by Delaloye et al ( Delaloye et al, 1994 ), one experienced constipation and the other transient bilateral hydronephrosis. Of twenty-two patients described by Sezeur et al ( Sezeur et al, 1999 ), two experienced flank pain (necessitating deflation of the TE between radiation sessions), and one required the TE to be removed because of an infection secondary to an injury to the bowel caused during TE positioning.…”

Laparoscopic insertion of pelvic tissue expander to prevent radiation enteritis prior to radiotherapy for prostate cancer

“…Heaviness is a common complaint of very large expanders[10]. Deep vein thrombosis with pulmonary embolism and constipation due to obstructive defecation have been reported[11,12]. More recent reports using smaller implants show them to be associated with fewer complications[13-17].…”

Protection of the small bowel during abdominal radiation therapy with a tissue expander prosthesis

“…The insertion of a silicone breast prosthesis into the abdominal cavity to prevent small bowel toxicity has been described previously. 14,15 The silicone prosthesis was secured by an omental sling and removal of the prosthesis required laparotomy. Previous studies have shown that leaving the prosthesis in the abdomen permanently could lead to severe vascular or other problems.…”