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Title: Parks coloanal pull-through anastomosis for severe, complicated radiation proctitis

Abstract

A variety of operations have been proposed for the treatment of radiation injuries of the rectum. In this study, the procedure advocated by the late Sir Alan Parks--resection of the diseased segment down to its points of fixation to the vagina, bladder or prostate; with perianal mucosal stripping of the anorectal segment and primary coloanal (pull-through) anastomosis--was performed in 11 patients. In two others, an attempt at colorectal anastomosis was abandoned because of extreme scarring in the pelvis. The procedures were done following definitive treatment of carcinoma of the rectum (seven patients), carcinoma of the cervix (two patients), carcinoma of the uterus (one patient), carcinoma of the ovary (one patient), seminoma (one patient), and carcinoma of the bladder (one patient). One patient died from a pulmonary embolus on the seventh postoperative day. Of the survivors with a coloanal anastomosis, all had successful closure of their temporary colostomies with follow-up from one to six years. In eight, continence was assessed as being good or excellent. Four patients required anastomotic dilation and another required a surgical procedure for anastomotic stricture. There was one instance each of reoperation for small bowel obstruction and ileocolic fistula. There were no instances of recurrence of hemorrhage,more » fistulas, perineal pain or tenesmus. The Parks procedure obviates the need for a difficult dissection of the lower rectum and separation of tissues damaged by radiation and avoids the need for eversion techniques. Its selective use is advocated for patients suffering from severe radiation injuries of the rectum.« less

Authors:
Publication Date:
Research Org.:
St. George's Hospital, London, England
OSTI Identifier:
5479658
Resource Type:
Journal Article
Journal Name:
Dis. Colon Rectum; (United States)
Additional Journal Information:
Journal Volume: 28:2
Country of Publication:
United States
Language:
English
Subject:
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; CARCINOMAS; RADIOTHERAPY; SIDE EFFECTS; RECTUM; RADIATION INJURIES; BLADDER; FEMALES; MALES; OVARIES; PATIENTS; PROSTATE; SURGERY; UTERUS; BIOLOGICAL EFFECTS; BIOLOGICAL RADIATION EFFECTS; BODY; DIGESTIVE SYSTEM; DISEASES; FEMALE GENITALS; GASTROINTESTINAL TRACT; GLANDS; GONADS; INJURIES; INTESTINES; LARGE INTESTINE; MALE GENITALS; MEDICINE; NEOPLASMS; NUCLEAR MEDICINE; ORGANS; RADIATION EFFECTS; RADIOLOGY; THERAPY; URINARY TRACT; 560151* - Radiation Effects on Animals- Man

Citation Formats

Gazet, J C. Parks coloanal pull-through anastomosis for severe, complicated radiation proctitis. United States: N. p., 1985. Web. doi:10.1007/BF02552659.
Gazet, J C. Parks coloanal pull-through anastomosis for severe, complicated radiation proctitis. United States. https://doi.org/10.1007/BF02552659
Gazet, J C. 1985. "Parks coloanal pull-through anastomosis for severe, complicated radiation proctitis". United States. https://doi.org/10.1007/BF02552659.
@article{osti_5479658,
title = {Parks coloanal pull-through anastomosis for severe, complicated radiation proctitis},
author = {Gazet, J C},
abstractNote = {A variety of operations have been proposed for the treatment of radiation injuries of the rectum. In this study, the procedure advocated by the late Sir Alan Parks--resection of the diseased segment down to its points of fixation to the vagina, bladder or prostate; with perianal mucosal stripping of the anorectal segment and primary coloanal (pull-through) anastomosis--was performed in 11 patients. In two others, an attempt at colorectal anastomosis was abandoned because of extreme scarring in the pelvis. The procedures were done following definitive treatment of carcinoma of the rectum (seven patients), carcinoma of the cervix (two patients), carcinoma of the uterus (one patient), carcinoma of the ovary (one patient), seminoma (one patient), and carcinoma of the bladder (one patient). One patient died from a pulmonary embolus on the seventh postoperative day. Of the survivors with a coloanal anastomosis, all had successful closure of their temporary colostomies with follow-up from one to six years. In eight, continence was assessed as being good or excellent. Four patients required anastomotic dilation and another required a surgical procedure for anastomotic stricture. There was one instance each of reoperation for small bowel obstruction and ileocolic fistula. There were no instances of recurrence of hemorrhage, fistulas, perineal pain or tenesmus. The Parks procedure obviates the need for a difficult dissection of the lower rectum and separation of tissues damaged by radiation and avoids the need for eversion techniques. Its selective use is advocated for patients suffering from severe radiation injuries of the rectum.},
doi = {10.1007/BF02552659},
url = {https://www.osti.gov/biblio/5479658}, journal = {Dis. Colon Rectum; (United States)},
number = ,
volume = 28:2,
place = {United States},
year = {Fri Feb 01 00:00:00 EST 1985},
month = {Fri Feb 01 00:00:00 EST 1985}
}