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| 篇名 |
Surgical Management of Radiation Enterocolitis |
| 作者 |
Ming-Cheng Chen, Hwei-Ming Wang, Feng-Fan Chiang,Joe-Bin Chen, Te-Hsin Chao, Hsiu-Feng Ma, Chou-Chen Chen |
| 卷期/出版年月 |
43卷5期 (2010/10) |
| 頁次 |
236-242 |
| 摘要 |
Background: Pelvic irradiation has been a popular therapy modality for treating
cervical cancer for many years, and its usage in rectal cancer and prostate cancer
cases is also on the rise. In this study we retrospectively analyzed cases of surgical
management for complications after pelvic irradiation. We also discuss the issue of
resection of diseased bowel and the safety of anastomosis.
Methods: From 1989 to 2007, a total of 31 patients in our hospital underwent
gastrointestinal tract surgery for complications of pelvic irradiation and were
enrolled in this study. A retrospective review was conducted for demographic data,
preoperative status, operative strategy and recurrence of radiation enterocolitis.
Results: For resection procedures, the mean length of hospital stay was 38.8 days
and 18.8 days for diversion procedures (p=0.003). 21(58%) patients underwent
resection procedures, and 15 (42%) patients underwent diversion procedures. The
complication rate was 57% for resection procedures and 13% for diversion
procedures (p=0.002). The mortality rate was 10% for resection procedures and 0
for diversion procedures (p=0.492). The total two-year recurrence rate for
symptomatic radiation enterocolitis was 25%, and the re-operation rate was 22%.
There was no significant difference in the recurrence rate and re-operation rate
between resection procedures and diversion procedures. There was also no
significant difference in the surgical outcome between the group with anastomosis
and that without anastomosis.
Conclusions: Surgery of radiation enterocolitis is associated with significant
morbidity and mortality rates. Conservative procedures, such as bypass, stoma and
stricturoplasty, should be considered for patients who are poor surgical candidates.
Anastomosis did not increase surgical morbidity or mortality rates. |
| 關鍵詞 |
radiation colitis, radiation enterocolitis, radiation injury, surgery,surgical management |
| 分類 |
Original Article |
|
