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《放射性直肠损伤多学科诊疗中国专家共识(2021年版)》解读

[Interpretation of Chinese expert consensus on multidisciplinary diagnosis and treatment of radiation rectal injury (2021 edition)].

作者信息

Ma T H

机构信息

Department of Colorectal Surgery, Division of Radiation Enterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2021 Nov 25;24(11):956-961. doi: 10.3760/cma.j.cn441530-20210923-00379.

Abstract

Although pelvic radiotherapy has played an important role in the treatment of malignant tumors, it is still difficult to avoid radiation damage within a certain period of time. In 2021, under the joint promotion of Colorectal Surgery Group of Chinese Medical Association Surgery Branch, Colorectal Surgeons Committee of Chinese Medical Doctor Association Surgeons Branch, Colorectal Surgeons Committee of Chinese Medical Doctor Association, and Colorectal Cancer Professional Committee of Chinese Anti-Cancer Association, Expert Group on Diagnosis and Treatment of Radiation Intestinal Injury has updated and formulated the 2021 edition of the "Chinese expert consensus on the multidisciplinary diagnosis and treatment of radiation rectal injury" (hereinafter referred to as "Consensus"). This Consensus edition has major changes compared with the "Chinese consensus on the diagnosis and treatment of radiation proctitis (2018)", which mainly updates in the following aspects: (1) adjusting the name of radiation rectal injury: the term "radiation proctitis" was adjusted to "radiation rectal injury"; (2) advocating the concept of pelvic integral injury and the multidisciplinary diagnosis and treatment model; (3) putting forward the clinical classification of diseases: the classification of the chronic rectal injury includes telangiectasia, ulcer, stenosis and mixed type; (4) carrying out individualized treatment based on the characteristics of the above-mentioned disease classification, and adjusting the recommended level of non-surgical treatment; (5) proposing specific guiding principles and details of surgical treatment: "damage control" and "expanded resection" principles, etc. This new edition (2021) of Consensus further refines the disease analysis and treatment strategies, which not only improves the guiding value of clinical practice, but also provides an important reference for the standardized diagnosis and treatment of radiation rectal injury in China.

摘要

尽管盆腔放疗在恶性肿瘤治疗中发挥了重要作用,但在一定时期内仍难以避免辐射损伤。2021年,在中华医学会外科学分会结直肠外科学组、中国医师协会外科医师分会结直肠外科医师委员会、中国医师协会结直肠外科医师委员会、中国抗癌协会结直肠癌专业委员会的共同推动下,放射性肠损伤诊治专家组更新并制定了《放射性直肠损伤多学科诊治中国专家共识(2021年版)》(以下简称《共识》)。与《放射性直肠炎诊断与治疗中国专家共识(2018年版)》相比,本版《共识》有较大变化,主要在以下方面进行了更新:(1)调整放射性直肠损伤名称:将“放射性直肠炎”一词调整为“放射性直肠损伤”;(2)倡导盆腔整体损伤概念和多学科诊治模式;(3)提出疾病临床分类:慢性直肠损伤分类包括毛细血管扩张型、溃疡型、狭窄型和混合型;(4)基于上述疾病分类特点进行个体化治疗,并调整非手术治疗推荐级别;(5)提出手术治疗的具体指导原则和细节:“损伤控制”和“扩大切除”原则等。本版(《共识》2021年版)进一步细化了疾病分析和治疗策略,不仅提高了对临床实践的指导价值,也为我国放射性直肠损伤的规范化诊治提供了重要参考。

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