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Related Experiment Videos

Intestinal failure after surgery for complicated radiation enteritis.

M Girvent1, G L Carlson, I Anderson

  • 1Intestinal Failure Unit, Hope Hospital, Manchester, UK.

Annals of the Royal College of Surgeons of England
|June 20, 2000
PubMed
Summary

Patients with intestinal failure due to radiation enteritis often require complex management. One-third of treated patients died in hospital, and another third needed home parenteral nutrition (HPN) for discharge.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Radiation Oncology

Background:

  • Radiation enteritis is a significant complication following pelvic radiotherapy.
  • Intestinal failure (IF) can arise from surgical interventions for radiation enteritis.
  • Tertiary Intestinal Failure Units (IFUs) manage complex cases of IF.

Purpose of the Study:

  • To evaluate the outcomes of patients referred to an IFU for complications of radiation enteritis.
  • To identify the primary issues and treatment strategies for radiation-induced intestinal failure.
  • To assess the role of surgery and home parenteral nutrition (HPN) in managing these patients.

Main Methods:

  • Retrospective review of 16 patients referred to a tertiary IFU between 1983 and 1997.
  • Analysis of patient demographics, primary malignancy site, prior surgeries, and presenting problems.

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  • Evaluation of treatment interventions including surgery and HPN, and patient outcomes.

    • Main Results:

    • 16 patients with radiation enteritis-induced IF were treated, with a majority being female and having genitourinary malignancies.
    • Common complications included intestinal fistulation, obstruction, and short bowel syndrome, often following multiple laparotomies.
    • Of 15 actively treated patients, 12 underwent surgery, 5 died in hospital, and 7 were discharged alive, with 2 requiring HPN.
    • A further 3 patients were discharged on HPN without further surgery.

    Conclusions:

    • Radiation enteritis poses a severe challenge, frequently necessitating complex surgical management and long-term nutritional support.
    • A significant proportion of patients with radiation-induced intestinal failure experience high morbidity and mortality.
    • Home parenteral nutrition (HPN) is a crucial intervention for selected patients, enabling discharge and improved quality of life.