Surgical Aspects of Intestinal Injury Due to Pelvic Radiotherapy

Abstract

Patients (71) with intestinal injury secondary to pelvic irradiation had predominantly large bowel lesions. Cases (17) were treated conservatively and 54 came to surgery, 28 patients having more than 1 operation. Following this essentially salvage surgery there were more ileal than colonic anastomotic leaks. Patients (34) died during the followup period (2-12 yr), 19 from recurrent malignancy, and 1 as a result of continuing radiation effects. Of the patients who had a radiation fistula, 70% died as a result of malignancy. Of 4200 cases of pelvic malignancy treated by irradiation over the decade 1972-1982. surgical referrals for complications constituted, 1.7%, with an overall radiation-related mortality of 0.2%. Colostomy alone has little part to play in this condition, and a policy based on excisional surgery is suggested.