Reconstructive surgery for the complications of pelvic irradiation

Journal Article · Wed Feb 01 04:00:00 EST 1984 · Am. J. Clin. Oncol.; (United States)

DOI:https://doi.org/10.1097/00000421-198402000-00011· OSTI ID:7013370

Bricker, E M; Johnston, W D; Kraybill, W G; Lopez, M J

Severe damage to the pelvic viscera is a complication of irradiation therapy that, unfortunately, cannot always be avoided. Resulting rectal and rectocolonic strictures, rectovaginal fistulas, and shortening and stenosis of the vagina present very difficult problems that frequently require a colostomy for relief and may permanently impair sexual function. The authors present a new approach to correction of these unfortunate lesions based on the use of proximal nonirradiated colon which serves as a vascular pedicle graft to correct the defect without a complicated and massive resection. Twenty-two such operations have been done with 19 satisfactory to excellent results and two total failures (one death from small bowel complications). All patterns and combinations of irradiation injury have been found amenable to this technique of repair. These have included both web and linear strictures with and without fistulas. In half of the patients, it was possible to make use of normal colon bypassed by a prior colostomy. Normal nonirradiated colon with good blood supply will heal satisfactorily to irradiated colon or rectum, thus making excision of all the irradiated tissue unnecessary. The results of this surgical approach have thus far been gratifying and warrant further trials for these distressing injuries.

• Research Organization: Washington Univ. of Medicine, St. Louis, MO
• OSTI ID: 7013370
• Journal Information: Am. J. Clin. Oncol.; (United States), Journal Name: Am. J. Clin. Oncol.; (United States) Vol. 7:1; ISSN AJCOD
• Country of Publication: United States
• Language: English

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.
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BODY AREAS
DIGESTIVE SYSTEM
FEMALE GENITALS
GASTROINTESTINAL TRACT
GRAFTS
INTESTINES
LARGE INTESTINE
MEDICINE
NUCLEAR MEDICINE
ORGANS
PATIENTS
PELVIS
POST-IRRADIATION THERAPY
RADIATION EFFECTS
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
SURGERY
THERAPY
TRANSPLANTS