Late gastrointestinal disorders after rectal cancer surgery with and without preoperative radiation therapy

Background: The aim of the study was to analyse late gastrointestinal disorders necessitating hospital admission following rectal cancer surgery and to determine their relationship to preoperative radiation therapy. Methods: Curatively treated patients participating in the Swedish Rectal Cancer Tria...

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Bibliographic Details
Published in:	British journal of surgery 2008-02, Vol.95 (2), p.206-213
Main Authors:	Birgisson, H., Påhlman, L., Gunnarsson, U., Glimelius, B.
Format:	Article
Language:	eng
Subjects:	Abdominal Pain - etiology Abdominal Pain - surgery Abdominal Pain/etiology/surgery Aged Biological and medical sciences Combined Modality Therapy Gastroenterology. Liver. Pancreas. Abdomen Gastrointestinal Diseases - etiology General aspects Humans Intestinal Fistula - etiology Intestinal Fistula - surgery Intestinal Fistula/etiology/surgery Intestinal Obstruction - etiology Intestinal Obstruction - surgery Intestinal Obstruction/etiology/surgery Intestine, Small Medical sciences MEDICIN Medicin och hälsovetenskap MEDICINE Patient Readmission - statistics & numerical data Postoperative Complications - etiology Preoperative Care - methods Rectal Neoplasms - radiotherapy Rectal Neoplasms - surgery Rectal Neoplasms/radiotherapy/surgery Reoperation Risk Factors Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surgical Wound Dehiscence - etiology Treatment Outcome Tumors
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Summary:	Background: The aim of the study was to analyse late gastrointestinal disorders necessitating hospital admission following rectal cancer surgery and to determine their relationship to preoperative radiation therapy. Methods: Curatively treated patients participating in the Swedish Rectal Cancer Trial during 1987–1990, randomized to preoperative irradiation (454 patients) or surgery alone (454), were matched against the Swedish Hospital Discharge Registry. Hospital records for patients admitted with gastrointestinal diagnoses were reviewed. Results: Irradiated patients had an increased relative risk (RR) of late small bowel obstruction (RR 2·49 (95 per cent confidence interval (c.i.) 1·48 to 4·19)) and abdominal pain (RR 2·09 (95 per cent c.i. 1·03 to 4·24)) compared with patients treated by surgery alone. The risk of late small bowel obstruction requiring surgery was greatly increased (RR 7·42 (95 per cent c.i. 2·23 to 24·66)). Irradiated patients with postoperative anastomotic leakage were at increased risk for late small bowel obstruction (RR 2·99 (95 per cent c.i. 1·07 to 8·31)). The risk of small bowel obstruction was also related to the radiation technique and energy used. Conclusion: Small bowel obstruction is more common in patients with rectal cancer treated with preoperative radiation therapy. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Increases risk of obstruction
ISSN:	0007-1323 1365-2168 1365-2168