Surgical procedures for digestive fistulae caused by radiation therapy.
OBJECTIVE
We evaluated the effectiveness of surgery to treat ileal fistulations associated with radiation exposure. SUBJECTS. An ileal fistula developed in eight patients, 13-102 months after 60 Gy of irradiation to the pelvic cavity, given as initial treatment or supportive therapy following resection of the primary tumor. The underlying diseases were cervical cancer in seven women and bladder cancer in one man.


RESULTS
Two patients had an ileorectal fistula, two had an ileosigmoidal fistula, three had an ileovesical fistula, and one had an ileourethral fistula. We performed a partial enterectomy in one patient, a simple bypass operation without exclusion in one, and bypass operations with exclusion in the other six. Intestinal expansion in the exclusion site occurred in one patient, but there were no other complications related directly to surgery, such as sutural insufficiency. The patient who underwent a simple bypass operation died of emaciation 2 months after the surgery, but all of the other patients were discharged capable of oral ingestion.


CONCLUSIONS
Our findings showed that surgery was beneficial for alleviating the various conditions related to digestive fistulation following radiation therapy.
Division of Gastroenterological Surgery, Chiba Cancer Center Hospital, 666-2 Nitona-cho, Chuo-ku, Chiba 260-8717, Japan.
Satoshi
S
Watanabe
Ichiro
I
Honda
Kazuo
K
Watanabe
Matsuo
M
Nagata
Hiroshi
H
Yamamoto
Hiroaki
H
Soda
Kentaro
K
Tasaki
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology / Q000601:surgery*; D007412:Intestinal Fistula / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000601:surgery*