Reconstructive surgery for the complications of pelvic irradiation
Severe damage to the pelvic viscera is a complication of irradiation therapy that, unfortunately, cannot always be avoided. Resulting rectal and rectocolonic strictures, rectovaginal fistulas, and shortening and stenosis of the vagina present very difficult problems that frequently require a colostomy for relief and may permanently impair sexual function. The authors present a new approach to correction of these unfortunate lesions based on the use of proximal nonirradiated colon which serves as a vascular pedicle graft to correct the defect without a complicated and massive resection. Twenty-two such operations have been done with 19 satisfactory to excellent results and two total failures (one death from small bowel complications). All patterns and combinations of irradiation injury have been found amenable to this technique of repair. These have included both web and linear strictures with and without fistulas. In half of the patients, it was possible to make use of normal colon bypassed by a prior colostomy. Normal nonirradiated colon with good blood supply will heal satisfactorily to irradiated colon or rectum, thus making excision of all the irradiated tissue unnecessary. The results of this surgical approach have thus far been gratifying and warrant further trials for these distressing injuries.
- Research Organization:
- Washington Univ. of Medicine, St. Louis, MO
- OSTI ID:
- 7013370
- Journal Information:
- Am. J. Clin. Oncol.; (United States), Vol. 7:1
- Country of Publication:
- United States
- Language:
- English
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62 RADIOLOGY AND NUCLEAR MEDICINE
FEMALE GENITALS
BIOLOGICAL RADIATION EFFECTS
POST-IRRADIATION THERAPY
LARGE INTESTINE
RADIOTHERAPY
SIDE EFFECTS
GRAFTS
PATIENTS
PELVIS
SURGERY
BIOLOGICAL EFFECTS
BODY
BODY AREAS
DIGESTIVE SYSTEM
GASTROINTESTINAL TRACT
INTESTINES
MEDICINE
NUCLEAR MEDICINE
ORGANS
RADIATION EFFECTS
RADIOLOGY
THERAPY
TRANSPLANTS
560151* - Radiation Effects on Animals- Man
550603 - Medicine- External Radiation in Therapy- (1980-)