Reappraisal of Surgical Treatment for Radiation Enteritis

Although radiation enteritis is a well‐recognized sequel of therapeutic irradiation, the standard surgical method is not universally agreed upon. Not only the short‐term effect but also the long‐term effect after a surgical intervention has been fairly well reported. To reassess the surgical therapy...

Full description

Saved in:
Bibliographic Details
Published in:World journal of surgery 2005-04, Vol.29 (4), p.459-463
Main Authors: Onodera, Hisashi, Nagayama, Satoshi, Mori, Akira, Fujimoto, Akihisa, Tachibana, Tsuyoshi, Yonenaga, Yoshikuni
Format: Article
Language:English
Subjects:
Adult
Aged
Anastomotic Leakage Rate
Biological and medical sciences
Defecation
Enteritis - etiology
Enteritis - mortality
Enteritis - physiopathology
Enteritis - surgery
Female
General aspects
Genital Neoplasms, Female - radiotherapy
Humans
Intestinal Obstruction - surgery
Intestinal Resection
Male
Medical sciences
Middle Aged
Proctocolectomy, Restorative
Quality of Life
Radiation Enteritis
Radiation Injuries - surgery
Retrospective Studies
Short Bowel Syndrome
Urologic Complication
Urologic Neoplasms - surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Although radiation enteritis is a well‐recognized sequel of therapeutic irradiation, the standard surgical method is not universally agreed upon. Not only the short‐term effect but also the long‐term effect after a surgical intervention has been fairly well reported. To reassess the surgical therapy for radiation enteritis, we retrospectively analyzed 48 patients (5 males and 43 females, mean age 58.6 years) who had been operated on in our department. These patients were divided into two types according to the time of surgery or the clinical manifestation, and operative methods were analyzed. Patient’s status such as bowel movement, body weight, and serum albumin value after surgery were analyzed, together with the patients survival. Our surgical methods were small intestinal resection for the intestinal obstruction, and pull‐through reconstruction for proctitis. Two patients died of multiple organ failure caused by perforated peritonitis irrespective of emergent operation. Although the overall morbidity was 21.7%, there was no leakage when bowels were anastomosed. Overall survival after radiation‐related complication in patients without previous neoplastic disease recurrence was 89%, 79%, and 69%, at 1, 3, and 5 years after surgery, respectively. Bowel motility, serum albumin level, and body weight recovered gradually soon after the operation and reached satisfactory levels within 6 months. Our analysis showed that small bowel injury should be treated by generous resection of the affected bowel followed by careful anastomosis of the disease‐free ends, while rectal resection is best dealt with by restorative proctectomy. This may provide a good quality of life and minimize major postoperative complications such as leakage.
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-004-7699-3