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Radiation-induced gastrointestinal fistulae
Annals of the Royal College of Surgeons of England
|January 1, 1986
Summary
Radiation-induced fistulae complicate radiation enteritis in 14% of patients, often presenting years after radiotherapy. Surgical management focuses on resection or exclusion due to patient unfitness for major surgery.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Radiation Oncology
Background:
- Radiation enteritis is a significant complication following pelvic radiotherapy.
- Radiation-induced fistulae represent a severe manifestation of radiation enteritis.
Purpose of the Study:
- To analyze the incidence, presentation, and management of radiation-induced fistulae in patients with radiation enteritis.
- To identify factors associated with fistula development and surgical outcomes.
Main Methods:
- Retrospective review of 70 patients with radiation enteritis treated between 1958 and 1984.
- Analysis of fistula incidence, latent period, associated lesions, and surgical procedures.
Main Results:
- 10 out of 70 patients (14%) developed radiation-induced fistulae.
- Median latent period was 20 months; fistulae were often multiple and associated with synchronous lesions.
- Patients with fistulae were more likely to have synchronous lesions than those with strictures (P=0.005).
Conclusions:
- Radiation-induced fistulae are a serious complication of radiation enteritis, occurring in a notable percentage of patients.
- Surgical intervention, typically wide resection and anastomosis or exclusion, is the preferred treatment, considering patients' frequent unfitness for major surgery.