The intestinal complications of radiotherapy

Abstract

The clinical features of 38 patients with intestinal complications after radiotherapy are recorded. Intestinal complications are commonly progressive and in this series led to the death of 14 patients (37 per cent). Nine of these patients had no sign of recurrent tumour. ‘Spontaneous’ necrosis of the irradiated bowel and necrosis of intestinal anastomoses after surgical operation carried a particularly high mortality. Only 3 patients (8 per cent) became completely asymptomatic after treatment of their bowel disease. Apparently localized radiation lesions in the small bowel were sometimes associated with severe malabsorption. Radiographs showed distinctive radiological patterns in the small bowel. A combined radiotherapy/surgical follow‐up clinic is advocated.

Management of Radiation Injuries to the Bowel Associated with Treatment of Uterine Carcinoma by Radiotherapy: Preliminary Communication

“…The follow-up period in this study is short and further complications are still to be expected, although more than 90% occur within two years of treatment (Wellwood & Jackson 1973). In this series of 200 patients, approximately half received intracavitary Cathetron treatment alone and none of these suffered any bowel injury.…”

Healing of experimental colonic anastomoses: Effects of combined preoperative high‐dose radiotherapy and intraperitoneal 5‐fluorouracil

“…Wellwood and Jackson [13] reported well-developed arterial sclerosis and an increase in the amount and density of fibrous tissue in the intestinal and colonic submucosa in patients who received abdominal irradiation for different reasons. Experimentally, an early and persistent reduction in colorectal anastomotic blood flow was found in pigs after preoperative radiation therapy with a total dose of 4,250 cGy [34].…”

“…Previously, we found that preoperative hyperfractionated RT with a total dose of 41.6 Gy did not affect the strength of colonic anastomosis in rats provided that one limb only of the anastomosis was irradiated [12]. Several studies, clinical and experimental, have reported histological changes in the small intestine and colon after RT [13][14][15][16]. Animal studies investigating the influence of combined RCT on colonic anastomosis have yielded conflicting results [17,18].…”

24. Probleme nach Strahlentherapie in der Chirurgie

“…Sie geht mit Schmerzen, Tenesmen, Durchfiillen und gelegentlich auch Blutungen einher. Solche Friihreaktionen klingen meist innerhalb einiger Wochen ab und erfordern in der Regel keine chirurgische Behandlung [16,19].…”