Brief Article
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World J Gastroenterol. Sep 21, 2011; 17(35): 4013-4016
Published online Sep 21, 2011. doi: 10.3748/wjg.v17.i35.4013
Practical approaches to effective management of intestinal radiation injury: Benefit of resectional surgery
Nikolaos Perrakis, Evangelos Athanassiou, Dimitra Vamvakopoulou, Maria Kyriazi, Haris Kappos, Nikolaos C Vamvakopoulos, Iakovos Nomikos
Nikolaos Perrakis, Maria Kyriazi, Haris Kappos, Iakovos Nomikos, Department of Surgery, Metaxa Cancer Memorial Hospital, Piraeus 11522, Greece
Evangelos Athanassiou, Department of Surgery, University of Thessalia Medical School, Larissa 41110, Greece
Dimitra Vamvakopoulou, Nikolaos C Vamvakopoulos, Department of Biology and Genetics, University of Thessalia Medical School, Larissa 41110, Greece
Author contributions: Nomikos I, Athanassiou E, Vamvakopoulos NC contributed to study concept and design; Perrakis N, Kyriazi M, Kappos H, Vamvakopoulou D contributed to acquisition of data; Athanassiou E, Vamvakopoulos NC, Nomikos I drafted the manuscript; Athanassiou E, Vamvakopoulou D critically reviewed the manuscript for important intellectual content.
Supported by The University Hospital of Larissa
Correspondence to: Evangelos Athanassiou, Associate Professor of Surgery, University Hospital of Larissa, Larissa 41110, Greece.
Telephone: +30-241-3501560  Fax: +30-241-3501560
Received: November 24, 2010
Revised: December 26, 2010
Accepted: January 2, 2011
Published online: September 21, 2011

AIM: To study the outcome of patients undergoing surgical resection of the bowel for sustained radiation-induced damage intractable to conservative management.

METHODS: During a 7-year period we operated on 17 cases (5 male, 12 female) admitted to our surgical department with intestinal radiation injury (IRI). They were originally treated for a pelvic malignancy by surgical resection followed by postoperative radiotherapy. During follow-up, they developed radiation enteritis requiring surgical treatment due to failure of conservative management.

RESULTS: IRI was located in the terminal ileum in 12 patients, in the rectum in 2 patients, in the descending colon in 2 patients, and in the cecum in one patient. All patients had resection of the affected region(s). There were no postoperative deaths, while 3 cases presented with postoperative complications (17.7%). All patients remained free of symptoms without evidence of recurrence of IRI for a median follow-up period of 42 mo (range, 6-96 mo).

CONCLUSION: We report a favorable outcome without IRI recurrence of 17 patients treated by resection of the diseased bowel segment.

Keywords: Pelvic neoplasms, Bowel, Radiation injuries, Surgery