New Technique to Avoid General Anesthesia during Brachytherapy for Cancer Cervix

Aim: To keep the cervical canal dilated after the fi rst high dose rate (HDR) brachytherapy fraction to avoid general anesthesia during subsequent applications. Patients and Methods: In the fi rst HDR brachytherapy application: examination and cervical dilatation was done under general anesthesia. The proximal 4 cm of urinary Foley catheter was cut (making the new cervical tube), inserted in the cervical canal and fi xed to the cervix by 3 simple silk sutures. Uterine tandem was inserted into the uterus through the new cervical tube and procedure was completed as usual. The new cervical tube was left in place after the end of the session. In the subsequent HDR brachytherapy applications: uterine tandem was inserted into the uterus through this new cervical tube without general anesthesia. All applications were evaluated by CT images and patients were treated according to CTimage-based 3D calculation. Results: In total: 9 HDR brachytherapy applications were done for 3 cancer cervix patients. For each patient: fi rst application was done under general anesthesia while 2nd and 3rd applications were done without general anesthesia (analgesia or sedation was given if needed). The uterine tandem was inserted easily and correctly with the new cervical tube in place. No complications occurred during or after the procedures. Conclusion: This is a simple new technique facilitating uterine tandem insertion without general anesthesia. Using this technique, patients can be protected from general anesthesia hazards (especially in risky patients) and time saved during brachytherapy applications. This new cervical tube is as safe and applicable as the cervical Smit sleeve; however, it is more available and cheaper. . Research Article New Technique to Avoid General Anesthesia during Brachytherapy for Cancer Cervix Ashraf H Hassouna* Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt Dates: Received: 07 December, 2016; Accepted: 28 December, 2016; Published: 30 December, 2016 *Corresponding author: Ashraf Hamed Hassouna, Professor of Radiation Oncology, Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt, Tel: +201000471593; E-mail: