Radiation injury of the rectum: evaluation of surgical treatment

Journal Article · Tue Dec 01 04:00:00 EST 1981 · Ann. Surg.; (United States)

DOI:https://doi.org/10.1097/00000658-198112000-00010· OSTI ID:5388788

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 wer 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 postoperative 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 sharp rise in the morbidity and mortality rates.

• Research Organization: The Department of Colon and Rectal Surgery, The Cleveland Clinic Foundation, OH
• OSTI ID: 5388788
• Journal Information: Ann. Surg.; (United States), Journal Name: Ann. Surg.; (United States) Vol. 194:6; ISSN ANSUA
• Country of Publication: United States
• Language: English

Related Subjects

550603 -- Medicine-- External Radiation in Therapy-- (1980-)
560151* -- Radiation Effects on Animals-- Man
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
DIGESTIVE SYSTEM
DIGESTIVE SYSTEM DISEASES
DISEASES
FISTULAE
GASTROINTESTINAL TRACT
INTESTINES
LARGE INTESTINE
MEDICINE
NUCLEAR MEDICINE
ORGANS
PATHOLOGICAL CHANGES
PATIENTS
POST-IRRADIATION THERAPY
PROCTITIS
RADIATION EFFECTS
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
RECTUM
SIDE EFFECTS
SMALL INTESTINE
SURGERY
THERAPY
UROGENITAL SYSTEM DISEASES