Repair of postirradiation damage to colorectum: a progress report

Journal Article · Fri May 01 04:00:00 EDT 1981 · Ann. Surg.; (United States)

DOI:https://doi.org/10.1097/00000658-198105000-00004· OSTI ID:5638229

Bricker, E M; Johnston, W D; Patwardhan, R V

The results of 21 operations for repair of rectovaginal fistula and/or stricture secondary to irradiation for pelvic cancer are presented. The operations rely on the use of proximal nonirradiated colon with normal blood supply for effecting the repair. In patients having had a previous colostomy, it is possible to use the proximal end of the bypassed colon for this purpose. There is minimal dissection of the rectal ampulla and the presacral space is never entered. Continuity is established by anastomosis to the anterior rectal wall via an abdominal approach alone, or by a combined abdominovaginal or abdominoperineal approach. It has been found that nonirradiated colon of normal vascularity can be expected to heal to irradiated colon or rectum, thus making the extensive resections associated with correction of these abnormalities unnecessary. The functional result in 18 of 19 patients who underwent this procedure was satisfactory to excellent. One patient had a poor result because of partial rectal incontinence. Two operations out of the 21 were total failures and one of these patients died of complications secondary to irradiation damage to the small intestine. One patient has not yet had final colostomy closure. The results are considered promising enough to warrant continued trial.

• OSTI ID: 5638229
• Journal Information: Ann. Surg.; (United States), Journal Name: Ann. Surg.; (United States) Vol. 193:5; ISSN ANSUA
• Country of Publication: United States
• Language: English

Related Subjects

550603* -- Medicine-- External Radiation in Therapy-- (1980-)
550900 -- Pathology
560151 -- Radiation Effects on Animals-- Man
59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BIOLOGICAL RECOVERY
BIOLOGICAL REPAIR
BODY
DIGESTIVE SYSTEM
FISTULAE
GASTROINTESTINAL TRACT
HEALING
INTESTINES
IRRADIATION
LARGE INTESTINE
LOCAL IRRADIATION
MEDICINE
NUCLEAR MEDICINE
ORGANS
PATHOLOGICAL CHANGES
PATIENTS
RADIATION EFFECTS
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
RECOVERY
REPAIR
SIDE EFFECTS
SURGERY
THERAPY