Repair of postirradiation damage to colorectum: a progress report

Journal Article · Fri May 01 00:00:00 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), Vol. 193:5
• Country of Publication: United States
• Language: English

Related Subjects

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