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

OncologyOncology 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

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
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