(P014) Absence of Infection From Injection of a Rectal Spacer Into the Anterior Perirectal Fat Space

April 21, 2015
Oncology, Oncology Vol 29 No 4_Suppl_1, Volume 29, Issue 4_Suppl_1

With proper preparation and antibiotics, placement of the rectal spacer into the anterior perirectal fat is extremely safe, without any risk of infection, in our series. Also, infections were not found in patients who had rectal wall penetration with the rectal spacer applicator needle.

Jekwon Yeh, MD, Justin Ren, Kenneth Tokita, MD, John Ravera, MD; Cancer Center of Irvine

OBJECTIVE/PURPOSE: There is now increasing literature to support the use of a rectal spacer to decrease rectal side effects during radiation for prostate cancer. A rectal spacer (polyethylene glycol hydrogel) is usually placed via transperineal injection behind Denonvillier’s fascia to enhance the separation between the prostate and rectum. This causes a decrease in radiation dose to the rectum. Occasionally, the needle can penetrate the rectal wall, and the spacer material is accidently injected into the rectal lumen. This study aims to evaluate the rate of infection from rectal spacer placement and in patients who experienced rectal wall penetration with the rectal spacer applicator needle.


MATERIALS AND METHODS: From January 2010 to May 2014, a total of 370 patients had arectal spacer placed via transperineal injection. Patients were instructed to perform an enema the night before and immediately prior to the surgery. The perineum was also sterilized with Betadine prior to the procedure. Patients also took ciprofloxacin 500 mg bid for 10 days, starting the day prior to the procedure. Patients also received gentamicin 80 mg and cefazolin 1 gram intraoperatively. Afterwards, a computed tomography (CT) scan and magnetic resonance imaging (MRI) were performed on all patients to confirm placement of the rectal spacer and for external beam radiation planning.

RESULTS: Out of 370 patients who received the hydrogel spacer, no patient developed a rectal infection. A total of 18 (5%) patients had known rectal penetration seen on imaging or clinically. None of these patients experienced any rectal infections.

CONCLUSIONS: With proper preparation and antibiotics, placement of the rectal spacer into the anterior perirectal fat is extremely safe, without any risk of infection, in our series. Also, infections were not found in patients who had rectal wall penetration with the rectal spacer applicator needle.

Proceedings of the 97th Annual Meeting of the American Radium Society - americanradiumsociety.org

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