Nakashima H, Ueo H, Shibuta K, Baba K, Kusumoto H, Haraguchi M, Mori M, Akiyoshi T
Department of Surgery, Kyushu University, Beppu, Japan.
Int Surg. 1996 Oct-Dec;81(4):415-8.
To improve the surgical outcome in patients with radiation enteritis, 18 female cases were analyzed. Out of the 18 cases, 3 (16.7%) were treated conservatively while 15 (83.3%) underwent surgical procedures. Thirteen out of 14 patients (92.8%) with ileus underwent an operation. The overall mortality was 22.2% (4 out of 18 cases). However, no significant difference in the mortality between the operated and non-operated cases was observed. Although an analysis of the 15 operated cases did not reveal any significant factors that might have affected the prognosis, all four patients who underwent a bypass operation showed a good postoperative course, with only one excepting being a patient suffering from malnutrition. Although only a small number of patients were included in this study, these results suggest that 1) surgeons should not hesitate to operate on patients with radiation enteritis demonstrating ileus, and 2) a bypass operation may be one surgical alternative in the presence of massive adhesion or for patients at high risk for a standard operation.
为改善放射性肠炎患者的手术效果,对18例女性患者进行了分析。18例患者中,3例(16.7%)接受保守治疗,15例(83.3%)接受了手术。14例肠梗阻患者中有13例(92.8%)接受了手术。总死亡率为22.2%(18例中有4例)。然而,手术组和非手术组之间的死亡率没有显著差异。虽然对15例手术病例的分析未发现任何可能影响预后的显著因素,但接受旁路手术的4例患者术后恢复良好,只有1例营养不良患者除外。尽管本研究纳入的患者数量较少,但这些结果表明:1)对于出现肠梗阻的放射性肠炎患者,外科医生应毫不犹豫地进行手术;2)在存在广泛粘连或标准手术风险较高的患者中,旁路手术可能是一种手术选择。