Laparoscopic Fenestration for Abscess Following SpaceOAR Placement-Case Report

Area of Science:

• Oncology
• Surgical Innovation
• Radiation Therapy Complications

Background:

• SpaceOAR hydrogel spacer is utilized to mitigate rectal toxicity during prostate cancer radiation therapy.
• Abscess formation is a rare but potential complication following SpaceOAR implantation.

Purpose of the Study:

• To report a case of a SpaceOAR-related abscess successfully treated with laparoscopic fenestration.
• To highlight laparoscopic fenestration as a treatment option for refractory rectal spacer abscesses.

Main Methods:

• A 70-year-old male patient with prostate cancer developed a SpaceOAR abscess 76 days post-implantation.
• Initial treatment with antibiotics and percutaneous drainage proved ineffective.
• Laparoscopic abscess fenestration was performed for definitive treatment.

Main Results:

• Laparoscopic fenestration led to significant abscess size reduction.
• The patient experienced clinical improvement and a favorable outcome post-procedure.
• This case demonstrates the efficacy of laparoscopic fenestration in managing SpaceOAR abscesses.

Conclusions:

• Abscess formation should be considered in the differential diagnosis of SpaceOAR complications, even beyond two months post-placement.
• Laparoscopic fenestration is a viable and effective treatment for SpaceOAR-related abscesses unresponsive to conservative management.
• This case represents the first reported instance of successful laparoscopic abscess fenestration for a SpaceOAR complication.