title: [Rectal perforation : A rare complication following radiotherapy].
abstract: BACKGROUND
  Radiotherapy in the treatment of prostate cancer is well established. Intestinal complications following radiotherapy are divided into acute and chronic toxicity. Chronic complications like perforation and fistula formation to the rectum are rare and difficult to treat.
  
  
  METHODS
  In case of chronic radiotherapy complications and particularly chronic fistula formation to the rectum, evidence is low. Therefore, an overview of the available literature of surgical therapy strategies is given.
  
  
  RESULTS
  Options for the treatment of acute intestinal toxicity are established and therapy algorithms exist. Therapy of acute rectal perforation covers primary suture repair with or without diversion stoma as well as primary rectal resection with or without primary restoring bowel continuity. In chronic rectal lesions and particularly in fistula formation to the rectum, abdominal treatment strategies are preferred with additional interposition of an omental flap or vascularized muscle flap.
  
  
  CONCLUSIONS
  Although evidence for surgical therapy strategies of the rare chronic rectourethral and rectovesical fistula is low, treatment is a real interdisciplinary challenge and should be provided in a specialized center.
authors.affiliation: Klinik für Allgemein-, Viszeral und Transplantationschirurgie, Uniklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland. mbinneboesel@ukaachen.de.
authors.forename: M
authors.initials: M
authors.lastname: Binnebösel
authors.affiliation: Klinik für Allgemein-, Viszeral und Transplantationschirurgie, Uniklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Lambertz
authors.affiliation: Klinik für Allgemein-, Viszeral und Transplantationschirurgie, Uniklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
authors.forename: C D
authors.initials: CD
authors.lastname: Klink
authors.affiliation: Klinik für Allgemein-, Viszeral und Transplantationschirurgie, Uniklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
authors.forename: U P
authors.initials: UP
authors.lastname: Neumann
mesh_terms: D013505:Digestive System Surgical Procedures / Q000379:methods; D004307:Dose-Response Relationship, Radiation; D019317:Evidence-Based Medicine; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D008297:Male; D059351:Organ Sparing Treatments / Q000379:methods; D011471:Prostatic Neoplasms / Q000150:complications / Q000532:radiotherapy; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D035583:Rare Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D012007:Rectum / Q000293:injuries* / Q000601:surgery*; D012307:Risk Factors; D016879:Salvage Therapy / Q000379:methods; D016896:Treatment Outcome
keywords: Fistula, rectourethral; Fistula, rectovesical; Prostate cancer; Prostatectomy; Salvage therapy