Right hemicolectomy and ileal resection with primary reanastomosis for irradiation injury of the terminal ileum

Journal Article · Sun Feb 01 04:00:00 EST 1987 · Gynecol. Oncol.; (United States)

DOI:https://doi.org/10.1016/0090-8258(87)90276-9· OSTI ID:6646009

Hoskins, W J; Burke, T W; Weiser, E B; Heller, P B; Grayson, J; Park, R C

Injury to the small intestine from pelvic irradiation increases in frequency when extended treatment fields are utilized and when radiation therapy follows a major abdominal operation. Recommended surgical correction of such injury has been intestinal bypass to avoid the excessive morbidity and mortality from anastamotic leaks associated with primary resection and anastomosis. Since 1980, eight patients with extensive ileal injury secondary to irradiation have been seen at the Naval Hospital Bethesda, Maryland. All patients had previously undergone an abdominal operation and three patients had irradiation utilizing extended fields. In all cases, right hemicolectomy and extended ileal resection were performed with primary anastamosis of the ileum to the ascending colon or the transverse colon. Operating time averaged 4 1/2 hr utilizing hand closure anastomoses and 2 1/2 hr with stapled anastomoses. All patients received postoperative hyperalimentation and six of eight patients received preoperative hyperalimentation. One operative death occurred in a patient with intestinal perforation who required multiple resections. The remaining seven patients experienced no serious complications and had rapid return of bowel function. Our experience indicates that wide ileal resection with right hemicolectomy and primary reanastomosis is an acceptable alternative to intestinal bypass for the treatment of severe irradiation injury, especially when performed with gastrointestinal stapling devices.

• Research Organization: Naval Hospital, Bethesda, MD
• OSTI ID: 6646009
• Journal Information: Gynecol. Oncol.; (United States), Journal Name: Gynecol. Oncol.; (United States) Vol. 2; ISSN GYNOA
• Country of Publication: United States
• Language: English

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560151* -- Radiation Effects on Animals-- Man
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
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BIOLOGICAL RADIATION EFFECTS
BODY
DIGESTIVE SYSTEM
GASTROINTESTINAL TRACT
INJURIES
INTESTINES
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ORGANS
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RADIATION EFFECTS
RADIATION INJURIES
RADIOLOGY
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SIDE EFFECTS
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