Radiation proctitis surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Overview
Surgery is not the first-line treatment option for patients with radiation proctitis.However it is usually reserved as a last resort for patients with refractory symptoms and complications.
Surgery
Surgery is not the first-line treatment option for patients with radiation proctitis as it can lead to severe post-operative complications which include:
- Significant bleeding
- Sepsis
- Inadvertent enterotomies
- Formation of fistula
- Short bowel syndrome due to extensive bowel resection
- Creation of blind loops due to excessively long bypassed segments
- Nonhealing of anastomoses performed on irradiated tissue
- Anastomotic leak with peritonitis sepsis
However it is usually reserved as a last resort for patients with:[1][2]
- Hx of unresponsiveness to medical or endoscopic treatment
- Hx of intractable symptoms/complications like stricture, pain, bleeding, perforation, or a fistula.
Surgical options for radiation proctitis include:
- excision
- urinary and fecal diversion (diverting stoma) and
- reconstruction of a coloanal J reservoir
References
- ↑ Lucarotti ME, Mountford RA, Bartolo DC (1991). "Surgical management of intestinal radiation injury". Dis Colon Rectum. 34 (10): 865–9. PMID 1914719.
- ↑ Wu XR, Liu XL, Katz S, Shen B (2015). "Pathogenesis, diagnosis, and management of ulcerative proctitis, chronic radiation proctopathy, and diversion proctitis". Inflamm Bowel Dis. 21 (3): 703–15. doi:10.1097/MIB.0000000000000227. PMID 25687266.