Postoperative and long term results of surgery for chronic radiation enteritis in 108 patients: B1


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Abstract

Aim:Chronic radiation enteritis (CRE) after radiotherapy of abdominal cancers occurs in 5-30%. Intestinal resection is often required but data are scarce. The aims of this study were to report the morbidity and mortality of surgery for CRE and the long-term survival.Method:From 1980 to 2009, all consecutive adult patients with CRE who underwent small bowel resection for CRE were studied.Results:One hundred and eight (95 women) patients were included. The first operation was performed after a median interval of 20 months [1-397] from the first symptom of CRE, mainly for stricture (n = 83; 77%), including ileocecal resection in 48(44%) of cases. At a median follow up of 73 [2-319] months, 263 surgicalprocedures had been performed. 25 (23%) patients underwent one surgicalprocedure only. Mortality was 2% and morbidity was 67% being similar whatever the number ofprocedures. 67 (62%) patients required reoperation for recurrence of CRE Cox regression analysis identified three independent risk factors for surgical recurrence, includingemergencypresentation (2.3-IC [1.3-4.1], P < 0.003), intraoperative bowel injury (2.3-IC [1.2-4.6], P < 0.015) and anastomotic leakage (2.9-IC [1.5-5.6], P < 0.001). Ileocecal resection was the only independentprotective factor for recurrence (0.23-IC [0.13-0.43], P < 0.0001).Conclusion:Various surgicalprocedures may be required for CRE and are associated with a high morbidity. Ileocecal resection mayprevent subsequent intervention

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