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Surgical experience with small bowel damage secondary to pelvic radiotherapy
A L Gidwani1, K Gardiner, J Clarke
1Department of Surgery, Royal Victoria Hospital, Belfast, UK. gidwanianand@hotmail.com
Background:
Patients undergoing pelvic radiotherapy are at risk of developing radiation enteritis. This study reviewed patients with radiation enteritis referred to a specialist colorectal unit.
Methods:
Patients referred with radiation enteritis secondary to pelvic radiotherapy (July 2001 to July 2005) were analysed regarding: indication, duration, dosage/fractionation of radiotherapy, nutritional/biochemical assessment, investigation, surgery, histopathology, and hospital stay.
Results:
Eleven patients underwent pelvic radiotherapy. The median interval between radiotherapy and referral was 17 months. The majority were nutritionally deficient at presentation (haemoglobin < 12 g/l: 91%; magnesium < 0.75 mmol/l: 64%; albumin < 35 g/l: 91%). Eight (73%) patients had either a BMI < 20 or weight loss of >10% within 3 months prior to referral. Radiation enteritis was diagnosed by preoperative radiology, laparotomy and at histopathology. All patients underwent surgery (resection/ilesotomy/bypass) and median post-operative stay was 24 days.
Conclusions:
Radiation enteritis is associated with prolonged symptoms. Majority of patients are undernourished and despite nutritional support a high morbidity is noted.
