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Review
. 2016 Jun;29(2):85-91.
doi: 10.1055/s-0036-1580632.

Radiation-Induced Problems in Colorectal Surgery

Jean H Ashburn  1 , Matthew F Kalady  1
Affiliations
Review

Radiation-Induced Problems in Colorectal Surgery

Jean H Ashburn et al. Clin Colon Rectal Surg. 2016 Jun.

Abstract

Radiotherapy not only plays a pivotal role in the cancer care pathways of many patients with pelvic malignancies, but can also lead to significant injury of normal tissue in the radiation field (pelvic radiation disease) that is sometimes as challenging to treat as the neoplasms themselves. Acute symptoms are usually self-limited and respond to medical therapy. Chronic symptoms often require operative intervention that is made hazardous by hostile surgical planes and unforgiving tissues. Management of these challenging patients is best guided by the utmost caution and humility.

Keywords: radiation enteritis or enteropathy; radiation proctitis; radiation-induced bowel damage.

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Figures

Fig. 1
Fig. 1
Endoscopic findings of radiation injury. (Reprinted with permission from Bo Shen, MD, Cleveland Clinic Foundation, 2015. All rights reserved.)
Fig. 2
Fig. 2
Control and division of mesenteric vessels of radiation-injured intestine. (Reprinted with permission from Cleveland Clinic Center for Medical Art and Photography, ©1996–2010. All rights reserved.)
Fig. 3
Fig. 3
Argon plasma coagulation to control rectal bleeding from radiation proctitis. (Reprinted with permission from Bo Shen, MD, Cleveland Clinic Foundation, 2015. All rights reserved.)
Fig. 4
Fig. 4
Turnbull–Cutait abdominoperineal pull-through with delayed coloanal anastomosis. Externalization of colonic conduit (left), followed by amputation and delayed anastomosis 7 days later (right). (Reprinted with permission from Cleveland Clinic Center for Medical Art and Photography, ©1996–2010. All rights reserved.)
See this image and copyright information in PMC

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