title: [Outcomes of chronic radiation intestinal injury treated with surgical interventions].
abstract: OBJECTIVE
  To explore the surgical approaches and clinical outcomes of chronic radiation intestinal injury (CRII).
  
  
  METHODS
  From January 1, 2001 to December 31, 2010, at Department of Surgery, Nanjing General Hospital of Nanjing Command a consecutive series of 206 CRII patients undergoing surgical interventions was reviewed retrospectively. There were 64 males and 142 females with an age range of (50 ± 11) years old. The indications, surgical approaches, surgical complications and mortality were analyzed.
  
  
  RESULTS
  206 CRII patients received 229 surgical treatment, 31 patients underwent two or more operations. The course of surgical interventions included intestinal obstruction (n = 142), intestinal fistula (n = 56), proctitis (n = 12), bleeding (n = 6) and others (n = 13). They underwent 229 laparotomies including intestinal resection and primary anastomosis (n = 142), intestinal resection and enterostomy (n = 57), exclusion of radiation-related gastrointestinal diseases (n = 14) and other procedures (n = 16). The occurrence rate of postoperative intestinal complications was 25.7% (53/206). Five patients (2.4%) died within the postoperative 28 days.
  
  
  CONCLUSIONS
  Surgery is often required for patients with chronic radiation-induced intestinal obstruction, fistula, hemorrhage and perforation, etc. Resection and primary anastomosis with undamaged segments may be performed safely in selected patients. And a judicious use of stoma can reduce the rates of major surgical mortality and morbidity.
authors.affiliation: Department of Surgery, Nanjing General Hospital of Nanjing Command, Nanjing, China.
authors.forename: You-sheng
authors.initials: YS
authors.lastname: Li
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Yuan-xin
authors.initials: YX
authors.lastname: Li
authors.forename: Jian-an
authors.initials: JA
authors.lastname: Ren
authors.forename: Wei-ming
authors.initials: WM
authors.lastname: Zhu
authors.forename: Yun-zhao
authors.initials: YZ
authors.lastname: Zhao
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Lei
authors.initials: L
authors.lastname: Zheng
authors.forename: Jie-shou
authors.initials: JS
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000150:complications / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate