A retrospective study of surgical treatment of chronic radiation enteritis.

BACKGROUND AND AIMS: We assessed the role of surgery in the management of patients with intestinal obstruction or enterocutaneous fistula after chronic radiation enteritis (CRE) referred to our department, a specialist gastrointestinal surgical center, and analysis was made for the success of surgery.

METHODS

A retrospective analysis was made of 156 patients receiving radiation therapy for malignancy from Jan 2000 to Nov 2010, among which 134 received surgery for intestinal or urinary complications. The demographic data, nutritional status, previous surgery, disease location and clinical manifestations, concomitant urinary complications, and surgical procedures were analyzed.

RESULTS

Although malnutrition was prevalent (84/156, 53.9%) in this group of patients, the majority of them (101/134, 75.4%) recovered uneventfully after surgery following nutrition therapy, and resection and anastomosis (102/134) was the predominant surgical procedure for radiation injury to the ileocecal region. Sixteen patients received surgery for radiation-induced urinary complications. There were 36 postoperative morbidities (26.87%), mainly wound complications (21/134), intestinal obstruction (5/134), and anastomotic dehiscence (3/134).

CONCLUSIONS

Surgery is justified for patients with bowel obstruction or fistula after CRE. A comprehensive perioperative management, especially perioperative nutrition therapy was important for the success of the surgery.