Surgical treatment of intestinal radiation injury

Journal Article · Thu Oct 01 04:00:00 EDT 1987 · J. Surg. Oncol.; (United States)

DOI:https://doi.org/10.1002/jso.2930360204· OSTI ID:5725990

Maekelae, J Ne; Nevasaari, K; Kairaluoma, M I

A review of 43 consecutive patients requiring operation for serious intestinal radiation injury was undertaken to elucidate the efficacy of surgical treatment. The most common site of radiation injury was the rectum (19 cases), followed by the small bowel (13 cases), the colon (7 cases), and the combination of these (4 cases). The overall operative mortality was 14%; morbidity, 47%; and the postoperative symptom-free period, 18 +/- 30 months. Colostomy (N = 20) carried the lowest risk of mortality, 0%, as compared with resection (N = 17) and bypass procedure (N = 6), which were accompanied by the mortalities of 24% and 33%, respectively. During the follow-up (3-13 years) 12 patients (28%) died of recurrent cancer and 9 patients (21%) of persistent radiation injury, which yielded an overall mortality of 65% after resection and 50% and 65% after bypass and colostomy procedures, respectively. Continuing radiation damage led to 15 late reoperations. Ten of these were performed after colostomy, four after resection, and one after bypass. We conclude that colostomy cannot be regarded as a preferred operative method, because it does not prevent the progression of radiation injury and because it is, for this reason, associated with a higher late-complication rate. A more radical surgery is recommended but with the limitation that the operative method must be adapted to the operative finding.

• Research Organization: Oulu Univ. Central Hospital, Finland
• OSTI ID: 5725990
• Journal Information: J. Surg. Oncol.; (United States), Journal Name: J. Surg. Oncol.; (United States) Vol. 36:2; ISSN JSONA
• Country of Publication: United States
• Language: English

Related Subjects

550600* -- Medicine
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
DISEASES
GASTROINTESTINAL TRACT
INJURIES
INTESTINES
MEDICINE
MORTALITY
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIATION EFFECTS
RADIATION INJURIES
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
SURGERY
THERAPY