Summary
During the period 1974–1980 39 patients underwent operations at the Prosper Hospital in Recklinghausen for radiation injuries to the rectum or rectosigmoid. They comprised 22 patients with rectovaginal fistulas, 6 with ulcers, 3 suffering from severe hemorrhagic proctitis, 5 with rectal strictures, 1 with necrosis, and 2 with radiation ulcers and carcinoma. A sphincter-saving operative method of treating postirradiation damage of the rectum is presented. The technique involves the peranal anastomosis of healthy colon to the midanal canal using a sleeve anastomosis. Technical and functional results of resectional surgery for the rectal complications of radiation therapy are reported. Subjectively, total continence was present in 78 %, only 1 patient was incontinent because of flatus and watery stools.
Zusammenfassung
Während der Periode 1974–1980 wurden im Prosper-Hospital Recklinghausen 39 Patienten wegen Strahlenschäden am Rectum oder Rectosigmoid operativ behandelt. Bei 22 Patienten lag eine Fistelbildung vor, bei 6 ein Rectumulcus, bei 3 eine schwere haemorrhagische Proktitis, bei 5 lag eine Rectumstriktur, bei einem weiteren eine Nekrose und bei 2 ein Rectumulcus kombiniert mit einem Carcinom vor. Es wurde eine sphinctererhaltende operative Methode für die Behandlung der Strahlenschäden am Rectum vorgestellt, technisch wurde eine peranale Anastomose zwischen dem gesunden Colon und dem mittleren Analkanal in der Sleeve-Technik durchgeführt. Es wird über technische und funktionelle Ergebnisse der resektierenden Chirurgie bei Rectumkomplikationen infolge Bestrahlung berichtet. 78% der Patienten waren subjektiv voll kontinent, bei 17% war die Kontinenz ausreichend und nur 1 Patient war für Flatus und dünnen Stuhl inkontinent.
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Athanasiadis, S., Girona, J. Die abdomino-endorectale Resektion mit peranaler Anastomose bei der Behandlung der radiogenen Rectumschäden. Langenbecks Arch Chiv 356, 51–59 (1982). https://doi.org/10.1007/BF01270602
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DOI: https://doi.org/10.1007/BF01270602