Radiation injury of the rectum: Evaluation of surgical treatment

Journal Article · Tue Dec 01 00:00:00 EST 1981 · Ann. Surg.; (United States)

DOI:https://doi.org/10.1097/00000658-198112000-00010· OSTI ID:5628992

Anseline, P F; Lavery, I C; Fazio, V W; Jagelman, D G; Weakley, F L

One hundred four patients, 80 women and 24 men, with radiation injury of the rectum following treatment for gynecologic and urologic malignancy were studied. In 50 patients, the rectal injury was treated surgically; 54 patients were treated conservatively. The age and sex distributions were the same in each group. In 63 patients, symptoms developed one month to one year after radiotherapy. The longest latent interval was 17 years. Of the 50 surgical patients, 23 had associated small bowel injury. The indications for surgery for the rectal injury were 1) proctitis unresponsive to conservative measures in 14 patients, 2) rectal stricture or fistula or both in 32, and 3) rectosigmoid perforation in four. Forty-one patients had external diversions. Eleven had intestinal continuity restored; six of the 11 had required the stoma for proctitis unresponsive to medical measures. Nineteen patients did not undergo colostomy closure, although symptoms were greatly improved. Diversion alone was insufficient treatment in the remaining 11 patients. Twenty-six patients died. The 12 deaths in the surgical group comprised four due to residual malignancy, four from post-operative complications, and four from unrelated causes. Of the 14 deaths in the nonsurgical group, 11 died of the primary malignancy and three of unrelated causes. Diversion is considered the safest form of treatment for rectovaginal fistulae, rectal strictures, and proctitis unresponsive to medical measures. Intestinal resection resulted in a sharp rise in the morbidity and mortality rates.

• Research Organization: Cleveland Clinic Foundation, OH
• OSTI ID: 5628992
• Journal Information: Ann. Surg.; (United States), Vol. 194:6
• Country of Publication: United States
• Language: English

Related Subjects

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
62 RADIOLOGY AND NUCLEAR MEDICINE
RADIOTHERAPY
SIDE EFFECTS
RECTUM
BIOLOGICAL RADIATION EFFECTS
BLADDER
NEOPLASMS
PATHOLOGICAL CHANGES
PATIENTS
POST-IRRADIATION THERAPY
RADIATION INJURIES
SURGERY
BIOLOGICAL EFFECTS
BODY
DIGESTIVE SYSTEM
DISEASES
GASTROINTESTINAL TRACT
INJURIES
INTESTINES
LARGE INTESTINE
MEDICINE
NUCLEAR MEDICINE
ORGANS
RADIATION EFFECTS
RADIOLOGY
THERAPY
URINARY TRACT
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