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Chronic radiation enteritis: a community hospital experience
M N Fenner1, P Sheehan, P J Nanavati
1Department of Surgery, Southern Illinois University School of Medicine, Springfield 62794-9230.
Journal of Surgical Oncology
|August 1, 1989
Summary
Surgical management for chronic radiation enteropathy often involves bowel resection. Enteroenterostomy bypass is a viable alternative for older patients with dense adhesions, offering comparable outcomes.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Radiation Oncology
Background:
- Chronic radiation enteropathy (CRE) is a significant complication of pelvic radiotherapy.
- Bowel obstruction is a common presentation of CRE, necessitating surgical intervention.
- Optimal surgical strategies for CRE remain debated.
Purpose of the Study:
- To evaluate the operative management of patients with chronic radiation enteropathy.
- To compare outcomes between different surgical approaches for CRE.
Main Methods:
- Retrospective review of 38 patients with CRE treated between 1974 and 1986.
- Exclusion of patients with recurrent cancer.
- Analysis of surgical procedures (bowel resection vs. bypass/ostomy) and patient outcomes.
Main Results:
- 71% of patients presented with bowel obstruction.
- Overall morbidity was 45% and postoperative mortality was 16%.
- Bypass group patients were significantly older (70.3 vs. 55.5 years), suggesting age influenced procedure choice.
Conclusions:
- Bowel resection is the preferred surgical approach for CRE.
- Enteroenterostomy bypass is a suitable alternative for patients with dense adhesions, particularly older individuals.
- No significant difference in outcomes was observed based on vascular disease, tumor site, procedure type, or radiation dose.