[Surgical treatment of severe radiation injuries of the small intestine and colon-rectum. Apropos of 85 patients surgically-treated at the Gustave-Roussy Institute].

Radiation lesions of the small intestine, colon and rectum were treated surgically in 85 patients between 1970 and 1983. These were serious complications in all cases involving the short-term vital prognosis in patients lacking signs of recurrence of cancer for which they had received radiotherapy. Immediate operative mortality was 26%. Anastomotic digestive fistulae complicated 31% of resection-anastomosis and 29% of internal bypass operations. During the next 2 years the progression of the chronic radiation lesions themselves required repeat operations due to further complications in 19% of patients, with an operative mortality of 33%. Rather than comparing efficacy of resection-anastomosis with that of internal bypass procedures they should be considered as complementary, since they have different indications. Based on the analysis of results and acquired experience, a surgical strategy is proposed for treating complicated radiation lesions of the intestines.