Wang Lei, Wang Jianping
Surgeon Branch of Chinese Medical Doctor Association, Colorectal Surgery Group of Surgery Branch in the Chinese Medical Association. Email:
Zhonghua Wei Chang Wai Ke Za Zhi. 2018 Dec 25;21(12):1321-1336.
Radiation proctitis denotes the radiation damage of rectum caused by radiotherapy to pelvic malignancy. The clinical practices of radiation proctitis should be fully considered from diagnosis, treatment and prevention. In order to determine appropriate treatment strategies, the diagnosis of radiation proctitis should be based on clinical symptoms, endoscopic findings, imaging and histopathology to assess severity of symptoms and stage of disease. In terms of treatment decisions, non-surgical interventions are generally applied to relieve major symptoms and avoid serious complications. Diverting colostomy and restorative resection are the main surgical treatments for patients with recurrent symptoms. In terms of prevention, radiation proctitis should be prevented by improvement of radiotherapy technology, physical protection and prophylactic medication. This guide aims to provide guidance for the clinical practices of radiation proctitis in China.
放射性直肠炎是指盆腔恶性肿瘤放疗引起的直肠放射性损伤。放射性直肠炎的临床实践应从诊断、治疗和预防等方面进行全面考虑。为确定合适的治疗策略，放射性直肠炎的诊断应基于临床症状、内镜检查结果、影像学检查及组织病理学检查，以评估症状严重程度和疾病分期。在治疗决策方面，非手术干预通常用于缓解主要症状并避免严重并发症。对于症状复发的患者，转流性结肠造口术和恢复性切除术是主要的手术治疗方法。在预防方面，应通过改进放疗技术、物理防护和预防性用药来预防放射性直肠炎。本指南旨在为我国放射性直肠炎的临床实践提供指导。
