Putz P, Gerard A
Acta Chir Belg. 1977 May-Jun;76(3):249-51.
Between 1968 and 1972, 33 patients with carcinoma of the colon or the rectum underwent a radical surgical procedure followed by adjuvant irradiation therapy. One month after surgery, 6,000 rads were delivered in 6 to 7 weeks. Five of these patients presented later a radiotherapy ileitis, colitis or rectitis. One of them developed a rectitis of the anastomotic area with important diarrheas treated by drugs only; a second presented bowel subobstructions induced by a radiotherapy ileitis and died in cachexy a few months later. The 3 other patients underwent surgery again; one of them for adhesions in the anastomotic area: a definite left colostomy was realized for a stenosic rectitis in the second patient; the last patient underwent surgery 4 times again and died from a rupture of the iliaca artery. Discussion on the observations made at surgery and on the surgical pathology data could explain the high rate of these iatrogenic lesions induced by radiotherapy.
1968年至1972年间,33例结肠癌或直肠癌患者接受了根治性手术,随后进行辅助放疗。术后1个月,在6至7周内给予6000拉德的辐射剂量。其中5例患者后来出现放射性回肠炎、结肠炎或直肠炎。其中1例出现吻合口区域直肠炎,伴有严重腹泻,仅通过药物治疗;第2例因放射性回肠炎导致肠道不完全梗阻,几个月后死于恶病质。另外3例患者再次接受手术;其中1例是因为吻合口区域粘连;第2例因直肠狭窄性直肠炎进行了永久性左结肠造口术;最后1例患者又接受了4次手术,死于髂动脉破裂。对手术中观察到的情况和手术病理数据的讨论可以解释放疗引起的这些医源性病变的高发生率。