title: Long-term outcome after extensive intestinal resection for chronic radiation enteritis.
abstract: BACKGROUND
  Management of chronic radiation enteritis is often controversial, particularly due to the risk of short bowel syndrome.
  
  
  METHODS
  One hundred and seven chronic radiation enteritis patients with short bowel syndrome were studied retrospectively between 1980 and 2009. Survival and home parenteral nutrition dependence rates were evaluated with univariate and multivariate analysis.
  
  
  RESULTS
  The survival probabilities were 93%, 67% and 44.5% at 1, 5 and 10 years, respectively. On multivariate analysis, survival was significantly decreased with residual neoplastic disease (HR=0.21 [0.11-0.38], p<0.001), an American Society of Anesthesiologists score >3 (HR=0.38 [0.20-0.73], p=0.004) and an age of chronic radiation enteritis diagnosis >60 years (HR=0.45 [0.22-0.89], p=0.02). The actuarial home parenteral nutrition dependence probabilities were 66%, 55% and 43% at 1, 2 and 3 years, respectively. On multivariate analysis, this dependence was significantly decreased when there was a residual small bowel length >100 cm (HR=0.35 [0.18-0.68], p=0.002), adaptive hyperphagia (HR=0.39 [0.17-0.87], p=0.02) and the absence of a definitive stoma (HR=0.48 [0.27-0.84], p=0.01).
  
  
  CONCLUSIONS
  The survival of patients with diffuse chronic radiation enteritis after extensive intestinal resection was good and was mainly influenced by underlying comorbidities. Almost two-thirds of patients were able to be weaned off home parenteral nutrition.
authors.affiliation: Department of Gastroenterology and Nutrition Support, Beaujon Hospital, APHP, Clichy, France. aurelien.amiot@bjn.aphp.fr
authors.forename: Aurelien
authors.initials: A
authors.lastname: Amiot
authors.forename: Francisca
authors.initials: F
authors.lastname: Joly
authors.forename: Jérémie H
authors.initials: JH
authors.lastname: Lefevre
authors.forename: Olivier
authors.initials: O
authors.lastname: Corcos
authors.forename: Frederic
authors.initials: F
authors.lastname: Bretagnol
authors.forename: Yoram
authors.initials: Y
authors.lastname: Bouhnik
authors.forename: Yves
authors.initials: Y
authors.lastname: Panis
authors.forename: Bernard
authors.initials: B
authors.lastname: Messing
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004751:Enteritis / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D016331:Parenteral Nutrition, Home / Q000706:statistics & numerical data*; D011832:Radiation Injuries / Q000150:complications* / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies; D012778:Short Bowel Syndrome / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome