Protection from radiation enteritis by an absorbable polyglycolic acid mesh sling

Area of Science:

• Oncology
• Surgical Innovation
• Radiation Oncology

Background:

• Pelvic radiation therapy is a common treatment for malignant pelvic tumors.
• Radiation-associated small bowel injury (RASBI) is a severe complication of this therapy.
• Current methods to mitigate RASBI are limited.

Purpose of the Study:

• To test the hypothesis that excluding the small bowel from the radiation field protects against RASBI.
• To evaluate the efficacy and safety of a novel surgical technique using a PGA mesh sling.

Main Methods:

• Twenty cebus monkeys underwent low anterior resection.
• Ten monkeys received an absorbable polyglycolic acid (PGA) mesh sling to support the small bowel out of the pelvis.
• All animals received 2000 rads of pelvic radiation; controls were untreated.

Main Results:

• Animals with PGA mesh slings maintained normal small bowel function and histology.
• Animals without mesh slings developed abnormal stool and blood values, with all dying from small bowel necrosis by 2 months.
• The PGA mesh was well-tolerated, with no infection or obstruction, and fully absorbed by 6 months.

Conclusions:

• Support of the small bowel out of the pelvis using an absorbable PGA mesh sling is an effective method to prevent RASBI.
• This technique offers a promising solution for mitigating a devastating side effect of pelvic radiation therapy.
• The procedure is safe and without apparent complications.