Late radiation injury of the colon and rectum. Surgical management and outcome

Journal Article · Tue Aug 01 04:00:00 EDT 1989 · Diseases of the Colon and Rectum; (USA)

DOI:https://doi.org/10.1007/BF02555774· OSTI ID:5472948

Kimose, H H; Fischer, L; Spjeldnaes, N; Wara, P ^[1]

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1. Aarhus Municipal Hospital (Denmark)

After a median latency of 2 years, the initial late colorectal radiation injuries in 182 patients were: stricture (37 percent), minor lesions (36 percent), rectovaginal fistula (22 percent), and gangrene or other fistulas (5 percent). Due to progression, new colorectal injuries, primarily stricture (55 percent) and fistula (42 percent), occurred in 68 patients (37 percent). Resection provided the best results. However, the resectability rate was low (46 percent) and resection was primarily performed in patients with a circumscript well-defined stricture of the proximal rectum or sigmoid colon with an anastomotic leakage rate of 5 percent. The prevailing management of 78 patients with fistula or stricture with synchronous fistula was defunctioning colostomy, primarily end-sigmoidostomy, providing fair results in half of the patients. Stomal complications occurred in 15 percent. The radiation-induced colorectal mortality was 8 percent. Colorectal fistula and associated radiation injuries of the urinary tract, and especially of the small bowel, were the major determinants of fatal outcome, yielding an overall radiation-induced mortality of 25 percent. After a median observation time of 13 years, half of the patients were alive at follow-up; 56 percent of these had a fair outcome whereas the remaining patients continued to have mild symptoms responding to conservative measures (34 percent) or disabling symptoms (10 percent).

• OSTI ID: 5472948
• Journal Information: Diseases of the Colon and Rectum; (USA), Journal Name: Diseases of the Colon and Rectum; (USA) Vol. 32:8; ISSN 0012-3706; ISSN DICRA
• Country of Publication: United States
• Language: English

Related Subjects

560151* -- Radiation Effects on Animals-- Man
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
DELAYED RADIATION EFFECTS
DIGESTIVE SYSTEM
FISTULAE
GASTROINTESTINAL TRACT
INJURIES
INTESTINES
LARGE INTESTINE
MEDICINE
NUCLEAR MEDICINE
ORGANS
PATHOLOGICAL CHANGES
PATIENTS
RADIATION EFFECTS
RADIATION INJURIES
RADIOLOGY
RADIOTHERAPY
RECTUM
SIDE EFFECTS
SURVIVAL CURVES
THERAPY