Abstract
Abdominal spacers are useful for maintaining the distance between the target tumors and surrounding tissues, such as the gastrointestinal tract, in patients treated with carbon ion radiotherapy. Surgical intervention to remove the spacers is sometimes necessary because of abdominal infections triggered by long-term spacer placement or intestinal perforation. Therefore, spacers that do not require surgical removal and provide effective drainage against abdominal infections are urgently needed. This study aimed to develop a spacer that could be removed non-surgically and one that provides the therapeutic effect of drainage in patients who receive carbon ion radiotherapy for abdominal tumors. A novel fan-shaped spacer was constructed from a film drain that was folded along the trigger line. Simple withdrawal of the trigger line caused the film drain to fold and the holding lines to become free. We performed laparoscopy-assisted insertion with pneumoperitoneum and blind removal of the spacer fourteen times using a porcine model. Saline in the abdominal cavity was effectively aspirated using the spacer. Our novel fan-shaped spacer could be removed safely without surgery and was able to drain fluid effectively from the abdominal cavity.
Highlights
For radiotherapy (RT), including carbon ion radiotherapy (C-ion RT) or for intensity-modulated radiation therapy (IMRT) of abdominal tumors, safety margins are needed around the clinical target tumor volume
Structure of the novel fan-shaped spacer made of folded-film drain and two kinds of lines
Our novel fan-shaped spacer was constructed from a film drain, a main drain, and a trigger line (Fig 1A)
Summary
This study aimed to develop a spacer that could be removed non-surgically and one that provides the therapeutic effect of drainage in patients who receive carbon ion radiotherapy for abdominal tumors. The purpose of this study was to develop a spacer that did not require surgical removal for C-ion RT, and one that functioned as a therapeutic drain in patients with abdominal infections
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