Li Ning, Zhu Wei-ming, Ren Jian-an, Li Yuan-xin, Zhao Yun-zhao, Jiang Zhi-wei, Li You-sheng, Li Jie-shou
Research Institute of General Surgery, Nanjing General Hospital of People's Liberation Army, Nanjing 21002, China.
Zhonghua Wai Ke Za Zhi. 2006 Jan 1;44(1):23-6.
To explore the surgical methods and the clinical results of chronic radiation enteritis.
Treatments were applied to forty-nine cases of chronic radiation enteritis complicated with intestinal obstruction, enterocutaneous fistula, intestinal stenosis, intestinal bleeding, severe proctocolitis and intestinal perforation, among whom 47 cases received an average of 2.8 +/- 2.1 operations. Twenty-six cases received resection of the injured segment with primary anastomosis, fourteen cases received intestinal resection and proximal enterostomy, among whom 6 ostomies were permanent, and another 8 cases received secondary ostomy closure. The injured intestinal segments were spared in 7 cases.
Forty-seven among 49 cases were cured (success rate, 96%) with no anastomotic leakage. Two patients died.
Surgical complications of chronic radiation enteritis should be managed operatively. The operative method should be chosen according to the general condition of the patients and the complexity of the abdomen. Perioperative management and proper selection of intestinal segments for anastomosis are essential for the success.
探讨慢性放射性肠炎的手术方法及临床疗效。
对49例合并肠梗阻、肠皮肤瘘、肠狭窄、肠出血、严重直肠结肠炎及肠穿孔的慢性放射性肠炎患者进行治疗,其中47例平均接受2.8±2.1次手术。26例行损伤肠段切除并一期吻合,14例行肠切除及近端造口术,其中6例造口为永久性,另8例行二期造口关闭。7例保留损伤肠段。
49例中47例治愈(成功率96%),无吻合口漏。2例患者死亡。
慢性放射性肠炎的手术并发症应采用手术治疗。手术方式应根据患者的一般情况及腹部情况的复杂程度选择。围手术期管理及正确选择吻合肠段是手术成功的关键。