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Operative management of radiation injuries of the intestinal tract

Journal Article · · Am. J. Surg.; (United States)
;
A review of forty cases of radiation-induced gastrointestinal injuries is presented. Based on this experience and reports in the literature, preoperative management and operative technics are discussed. The increased risk of radiation bowel injury is recognized in patients who have had previous operations. Preradiation contrast studies are advised to identify trapped loops of intestine in the pelvis. Small bowel resection is recommended with localized segments of disease. Bypass operations are preferable to avoid any extensive dissections. Bypass operations have anastomotic dehiscence rates similar to those of resections. Proctocolitis is usually managed by diverting colostomy, with resection in a few favorable cases or with treatment failures. Most rectovaginal fistulas are managed by permanent colostomy. Small bowel fistulas are best treated by bypass with partial or total exclusion rather than by primary resection. Vigorous preoperative and postoperative nutritional support and evaluation are vital because of the poor healing qualities of irradiated bowel. Multiple operative procedures should be anticipated because the natural history of radiation bowel injury is slowly progressive.
Research Organization:
Hartford Hospital, CT
OSTI ID:
5732924
Journal Information:
Am. J. Surg.; (United States), Journal Name: Am. J. Surg.; (United States) Vol. 137:4; ISSN AJSUA
Country of Publication:
United States
Language:
English

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Related Subjects

550603 -- Medicine-- External Radiation in Therapy-- (1980-)
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.
ABDOMEN
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BIOLOGICAL RECOVERY
BODY
BODY AREAS
DELAYED RADIATION EFFECTS
DIGESTIVE SYSTEM
DIGESTIVE SYSTEM DISEASES
DISEASES
ENTERITIS
FISTULAE
GASTROINTESTINAL TRACT
HEALING
INJURIES
INTESTINES
IRRADIATION
LARGE INTESTINE
LOCAL IRRADIATION
MALFORMATIONS
MEDICINE
NUCLEAR MEDICINE
ORGANS
PATHOLOGICAL CHANGES
PATIENTS
PELVIS
POST-IRRADIATION THERAPY
PROCTITIS
RADIATION EFFECTS
RADIATION INJURIES
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
RECOVERY
RECTUM
SIDE EFFECTS
SMALL INTESTINE
SURGERY
THERAPY