Surgical treatment of severe late radiation injury to the bowel: a retrospective analysis of 83 cases.
OBJECTIVE
The aim of this study was to determine the best surgical approach for the treatment of late radiation injury to the bowel.


METHODS
Clinical and follow-up charts of 83 patients operated in our institution for late radiation injury to the bowel were retrospectively reviewed. The type of operation (resection-anastomosis or bypass) mortality, postoperative complications and reoperation rate were recorded. Seventy-six underwent resection with immediate anastomosis. A bypass or viscerolysis was performed in only 7 patients.


RESULTS
Postoperative mortality was 2.4%, morbidity was 23. Twenty-seven patients underwent further surgery; early reoperation (within 1 month) was necessary in 12 (morbidity 41%). A late reoperation has been performed in 15 patients (no mortality, morbidity 53.5%).


CONCLUSIONS
From the results of our study it can be concluded that resection with immediate anastomosis for late radiation injury to the bowel is safe and should be the first option for these patients.
Muttillo
Irnerio A
IA
Dipartimento di Chirurgia Pietro Valdoni, Università degli Studi di Roma La Sapienza, Roma, Italia. bol.clch@tiscalinet.it
Elias
Dominique
D
Bolognese
Antonio
A
Ducreux
Michel
M
Cardi
Maurizio
M
Barbarosos
Apostolos
A
Lusinski
Antoine
A
Lasser
Philippe
P
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002423:Cause of Death; D015179:Colorectal Neoplasms / Q000532:radiotherapy; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000401:mortality / Q000601:surgery; D007415:Intestinal Obstruction / Q000401:mortality / Q000601:surgery; D007422:Intestines / Q000528:radiation effects* / Q000601:surgery; D007558:Italy; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000401:mortality / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011832:Radiation Injuries / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D014565:Urogenital Neoplasms / Q000532:radiotherapy