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Actinic rectitis--the role of colostomy
R S de Oliveira Filho1, R C Fogarolli, B M Rossi
1Departamento de Cirurgia Pélvicá, Hospital A. C. Camargo, Fundação Antonio Prudente, São Paulo, Brasil.
Revista Paulista De Medicina
|November 1, 1992
Summary
Colostomy effectively manages actinic rectitis in gynecological cancer patients unresponsive to clinical treatment. This surgical intervention offered significant symptom relief for most patients, improving quality of life.
Area of Science:
- Oncology
- Gastroenterology
- Radiation Oncology
Background:
- Actinic rectitis is a common complication of pelvic radiation therapy for gynecological malignancies.
- Clinical management of refractory actinic rectitis remains challenging.
Purpose of the Study:
- To evaluate the efficacy of colostomy in treating actinic rectitis (grades I and II) unresponsive to clinical management.
- To assess long-term outcomes and complications associated with colostomy for this condition.
Main Methods:
- Retrospective analysis of 10 women with actinic rectitis treated with transverse colostomy.
- Diagnosis and staging based on clinical findings, proctoscopy, and rectal biopsy.
- Median follow-up of 53 months post-colostomy.
Main Results:
- Eight patients achieved complete remission of actinic rectitis symptoms post-colostomy.
- One patient experienced symptom recurrence after 2 years; another had incomplete remission with improvement.
- Two patients with complete remission underwent successful colostomy closure; one required reversal due to a rectovaginal fistula.
Conclusions:
- Colostomy is an effective treatment option for selected patients with refractory actinic rectitis.
- While generally successful, potential complications like fistula formation and symptom recurrence should be considered.