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Management of Late Complications of Pelvic Radiation in the Rectum and Anus

A Review

  • Current Status
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: Radiotherapy has become one of the most important treatment modalities for human malignancy. Tumors affecting the organs of the pelvis are increasingly being irradiated for local treatment benefit, with the subsequent complication of anorectal injury of varying extent. The aim of this review is to determine how to manage the consequences of long-term effects of radiotherapy on the rectum and anus. METHODS: A comprehensive search of the literature with manual cross-referencing was performed using the MEDLINE, PubMed, and Cochrane Databases. RESULTS: Long-term manifestations of injury caused by pelvic radiotherapy include abscess and fistula formation, stricture, mucus discharge, urgency, tenesmus, diarrhea, increased risk of cancer, and most commonly, bleeding. Most patients present with several symptoms; however, usually one symptom dominates. CONCLUSIONS: Many of these symptoms are self-limiting, and mucosal complications may often be treated by nonsurgical methods such as topical formalin application, endoscopic argon plasma coagulation, and hyperbaric oxygen therapy. Conservative measures have not been shown to be of benefit if symptoms persist. Structural abnormalities and septic complications are likely to require surgery. Modern techniques in the delivery of radiotherapy help minimize the likelihood of rectal complications.

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References

  1. RA Kyle MA Shampo P Curie M Curie-Sklodowska (1979) ArticleTitle. JAMA 241 2511–2511

    Google Scholar 

  3. H Fiith F Ebeler (1915) ArticleTitleRoentgen-und Radium Therapie des Uteruskarzihoms Zbl Gyn 39 217–227

    Google Scholar 

  4. RD James PF Schofield (1985) ArticleTitleResection of “inoperable” rectal cancer following radiotherapy Br J Surg 72 279–281

    Google Scholar 

  5. TF Todd (1938) ArticleTitleRectal ulceration following irradiation treatment of carcinoma of the cervix Uteri Surg Gyn Obstet 67 617–631

    Google Scholar 

  6. P Chapuis (2001) ArticleTitleChallenge of radiation-induced rectal bleeding Aust N Z J Surg 71 200–201

    Google Scholar 

  7. A Bazan B Hontanilla (1999) ArticleTitleThe use of the rectus abdominis muscle and a Vicryl mesh to protect the small intestine and the rectus in radiation treatments to the lower pelvis Plast Reconstr Surg 103 746–747

    Google Scholar 

  8. IG Cunningham (1980) ArticleTitleThe management of radiation proctitis Aust N Z J Surg 50 172–178

    Google Scholar 

  9. M Ajlouni (1999) ArticleTitleRadiation-induced proctitis Curr Treat Options Gastroenterol 2 20–26

    Google Scholar 

  10. CJ Wang SW Leung HC Chen et al. (1998) ArticleTitleThe correlation of acute toxicity and late rectal injury in radiotherapy for cervical carcinoma Int J Radiat Oncol Biol Phys 40 85–91

    Google Scholar 

  11. TE Schultheiss WR Lee MA Hunt AL Hanlon RS Peter GE Hanks (1997) ArticleTitleLate GI and GU complications in the treatment of prostate cancer Int J Radiat Oncol Biol Phys 37 3–11

    Google Scholar 

  12. TJ Kinsella WD Bloomer (1980) ArticleTitleTolerance of the intestine to radiation therapy Surg Gynecol Obstet 151 273–284

    Google Scholar 

  13. J Crook B Esche N Futter (1996) ArticleTitleEffect of pelvic radiotherapy for prostate cancer on bowel, bladder, and sexual function Urology 47 387–394

    Google Scholar 

  14. AR Miller JA Martenson H Nelson et al. (1999) ArticleTitleThe incidence and clinical consequences of treatment-related bowel injury Int J Radiat Oncol Biol Phys 43 817–825

    Google Scholar 

  15. KH Cho CK Lee SH Levitt (1995) ArticleTitleProctitis after conventional external radiation therapy for prostate cancer Radiology 195 699–703

    Google Scholar 

  16. T Kimura H Iwagaki A Hizuta Y Nonaka N Tanaka K Orita (1995) ArticleTitleColorectal cancer after irradiation for cervical cancer—case reports Anticancer Res 15 557–558

    Google Scholar 

  17. NY Haboubi PF Schofield PL Rowland (1988) ArticleTitleThe light and electron microscopic features of early and late phase radiation-induced proctitis Am J Gastroenterol 83 1140–1144

    Google Scholar 

  18. PS Haselton N Carr PF Schofield (1985) ArticleTitleVascular changes in radiation bowel disease Histopathology 9 517–534

    Google Scholar 

  19. TF Sandeman (1980) ArticleTitleRadiation injury of the anorectal region Aust N Z J Surg 50 169–172

    Google Scholar 

  20. P Chapuis O Dent E Bokey et al. (1996) ArticleTitleThe development of a treatment protocol for patients with chronic radiation-induced rectal bleeding Aust N Z J Surg 66 680–685

    Google Scholar 

  21. AV Indaram V Visvalingam M Locke S Bank (2000) ArticleTitleMucosal cytokine production in radiation-induced proctosigmoiditis compared with inflammatory bowel disease Am J Gastroenterol 95 1221–1225

    Google Scholar 

  22. SA Cooke NG De Moor (1981) ArticleTitleThe surgical treatment of the radiation-damaged rectum Br J Surg 68 488–492

    Google Scholar 

  23. JM Pearson S Kumar DM Butterworth PF Schofield NY Haboubi (1992) ArticleTitleFlow cytometric DNA characteristics of radiation colitis—a preliminary study Anticancer Res 12 1647–1649

    Google Scholar 

  24. SW Jao RW Beart SuffixJr HM Reiman LL Gunderson DM Ilstrup (1987) ArticleTitleColon and anorectal cancer after pelvic irradiation Dis Colon Rectum 30 953–958

    Google Scholar 

  25. R Greenwald JS Barkin GT Hensley MH Kalser (1978) ArticleTitleCancer of the colon as a late sequel of pelvic irradiation Am J Gastroenterol 69 196–198

    Google Scholar 

  26. AR Miller JA Martenson H Nelson et al. (1999) ArticleTitleThe incidence and clinical consequences of treatment-related bowel injury Int J Radiat Oncol Biol Phys 43 817–825

    Google Scholar 

  27. JP Gerard C Xie C Carrie et al. (1999) ArticleTitleCurative external beam radiotherapy for prostate carcinoma Aust N Z J Surg 69 707–711

    Google Scholar 

  28. T Azhar F Lopez (1989) ArticleTitleClinical patterns and treatment complications of 1000 cases of carcinoma of the uterine cervix Med J Malaysia 44 104–110

    Google Scholar 

  29. EM Moore TJ Magrino PA Johnstone (2000) ArticleTitleRectal bleeding after radiation therapy for prostate cancer Radiology 217 215–218

    Google Scholar 

  30. VS Swaroop CJ Gostout (1998) ArticleTitleEndoscopic treatment of chronic radiation proctopathy J Clin Gastroenterol 27 36–40

    Google Scholar 

  31. RR Babb (1996) ArticleTitleRadiation proctitis Am J Gastroenterol 91 1309–1311

    Google Scholar 

  32. SW Jao RW Beart SuffixJr LL Gunderson (1986) ArticleTitleSurgical treatment of radiation injuries of the colon and rectum Am J Surg 151 272–277

    Google Scholar 

  33. JW Denham PC O’Brien RH Dunstan et al. (1999) ArticleTitleIs there more than one late radiation proctitis syndrome? Radiother Oncol 51 43–53

    Google Scholar 

  34. NH Gilinsky DG Burns GO Barbezat W Levin HS Myers IN Marks (1983) ArticleTitleThe natural history of radiation-induced proctosigmoiditis Q J Med 52 40–53

    Google Scholar 

  35. M Reichelderfer JF Morrissey (1980) ArticleTitleColonoscopy in radiation colitis Gastrointest Endosc 26 41–43

    Google Scholar 

  36. FC den Hartog Jager P Cohen M van Haastert (1989) ArticleTitleLate radiation injury of the rectum and sigmoid colon Br J Radiol 62 807–812

    Google Scholar 

  37. D Hayne CJ Vaizey PB Boulos (2001) ArticleTitleAnorectal injury following pelvic radiotherapy Br J Surg 88 1037–1048

    Google Scholar 

  38. TA Arulampalam DC Costa M Loizidou et al. (2001) ArticleTitlePositron emission tomography and colorectal cancer Br J Surg 88 176–189

    Google Scholar 

  39. PP Tagkalidis JJ Tjandra (2001) ArticleTitleChronic radiation proctitis Aust N Z J Surg 71 230–237

    Google Scholar 

  40. JS Varma AN Smith A Busuttil (1985) ArticleTitleCorrelation of clinical and manometric abnormalities of rectal function following chronic radiation injury Br J Surg 72 875–878

    Google Scholar 

  41. GE Kim JJ Lim W Park et al. (1998) ArticleTitleSensory and motor dysfunction assessed by anorectal manometry in uterine cervical carcinoma patients with radiation-induced late rectal complication Int J Radiat Oncol Biol Phys 41 835–841

    Google Scholar 

  42. EH Birnbaum Z Dreznik RJ Myerson et al. (1992) ArticleTitleEarly effect of external beam radiation therapy on the anal sphincter Dis Colon Rectum. 35 757–761

    Google Scholar 

  43. TG Allen-Mersh EJ Wilson HF Hope-Stone CV Mann (1987) ArticleTitleThe management of late radiation-induced rectal injury after treatment of carcinoma of the uterus Surg Gynecol Obstet 164 521–524

    Google Scholar 

  44. S Jahnson O Westerborn B Gerdin (1992) ArticleTitlePrognosis of surgically treated radiation-induced damage to the intestine Eur J Surg Oncol 18 487–493

    Google Scholar 

  45. JJ De Cosse RS Rhodes WB Wentz JW Reagan HJ Dworken WD Holden (1969) ArticleTitleThe natural history and management of radiation-induced injury of the gastrointestinal tract Ann Surg 170 369–384

    Google Scholar 

  46. RM Lanciano K Martz GS Montana GE Hanks (1992) ArticleTitleInfluence of age, prior abdominal surgery, fraction size, and dose on complications after radiation therapy for squamous cell cancer of the uterine cervix Cancer 69 2124–2130

    Google Scholar 

  47. PF Anseline IC Lavery VW Fazio DG Jagelman FL Weakley (1981) ArticleTitleRadiation injury of the rectum Ann Surg 194 716–724

    Google Scholar 

  48. CA Perez S Fox MA Lockett et al. (1991) ArticleTitleImpact of dose in outcome of irradiation alone in carcinoma of the uterine cervix Int J Radiat Oncol Biol Phys 21 885–898

    Google Scholar 

  49. S Kan M Chun YM Jin et al. (2000) ArticleTitleA rat model for radiation-induced proctitis J Korean Med Sci 15 682–689

    Google Scholar 

  50. EJ Hall PB Schiff GE Hanks et al. (1998) ArticleTitleA preliminary report Cancer J Sci Am 4 385–389

    Google Scholar 

  51. JP Gerard C Xie C Carrie et al. (1999) ArticleTitleCurative external beam radiotherapy for prostate carcinoma Aust N Z J Surg 69 707–711

    Google Scholar 

  52. CA Perez HK Lee A Georgiou MA Lockett (1994) ArticleTitleTechnical factors affecting morbidity in definitive irradiation for localized carcinoma of the prostate Int J Radiat Oncol Biol Phys 28 811–819

    Google Scholar 

  53. CA Perez S Breaux JM Bedwinek et al. (1984) ArticleTitleRadiation therapy alone in the treatment of carcinoma of the uterine cervix Cancer 54 235–246

    Google Scholar 

  54. EY Huang H Lin HC Hsu et al. (2000) ArticleTitleHigh external parametrial dose can increase the probability of radiation proctitis in patients with uterine cervix cancer Gynecol Oncol 79 406–410

    Google Scholar 

  55. MD Weil ED Crawford P Cornish et al. (2000) ArticleTitleMinimal toxicity with 3-FAT radiotherapy of prostate cancer Semin Urol Oncol 18 127–132

    Google Scholar 

  56. JD Slater LT Yonemoto CJ Rossi SuffixJr et al. (1998) ArticleTitleConformal proton therapy for prostate carcinoma Int J Radiat Oncol Biol Phys 42 299–304

    Google Scholar 

  57. CA Perez JM Michalski JA Purdy TH Wasserman K Williams MA Lockett (2000) ArticleTitleThree-dimensional conformal therapy or standard irradiation in localized carcinoma of prostate Int J Radiat Oncol Biol Phys 47 629–637

    Google Scholar 

  58. DP Dearnaley VS Khoo AR Norman et al. (1999) ArticleTitleComparison of radiation side-effects of conformal and conventional radiotherapy in prostate cancer Lancet 353 267–272

    Google Scholar 

  59. DC Beyer JB Priestley SuffixJr (1997) ArticleTitleBiochemical disease-free survival following 125I prostate implantation Int J Radiat Oncol Biol Phys 37 559–563

    Google Scholar 

  60. GS Merrick WM Butler AT Dorsey JH Lief HL Walbert HJ Blatt (1999) ArticleTitleRectal dosimetric analysis following prostate brachytherapy Int J Radiat Oncol Biol Phys 43 1021–1027

    Google Scholar 

  61. J Skarlatos M Koukourakis H Zambatis et al. (1994) ArticleTitleTransurethral 137Cs medium dose rate radiotherapy as a boost for small-sized localized prostatic carcinomas Urol Int 53 209–213

    Google Scholar 

  62. KM Snyder RG Stock SM Hong YC Lo NN Stone (2001) ArticleTitleDefining the risk of developing grade 2 proctitis following 125I prostate brachytherapy using a rectal dose-volume histogram analysis Int J Radiat Oncol Biol Phys 50 335–341

    Google Scholar 

  63. BH Han KC Demel K Wallner W Ellis L Young K Russell (2001) ArticleTitlePatient reported complications after prostate brachytherapy J Urol 166 953–957

    Google Scholar 

  64. T Arimoto T Kitagawa H Tsujii K Ohhara (1991) ArticleTitleHigh-energy proton beam radiation therapy for gynecologic malignancies. Potential of proton beam as an alternative to brachytherapy Cancer 68 79–83

    Google Scholar 

  65. E Verastegui-Aviles A Mohar A Mota A Guadarrama J De La Garza-Salazar (1999) ArticleTitleCombination of radiation therapy and interferon alpha-2b in patients with advanced cervical carcinoma Int J Gynecol Cancer 9 401–405

    Google Scholar 

  66. NG Huilgol N Chatterjee BB Singh (1996) ArticleTitleAssessment of chlorpromazine as radiation sensitizer and protector. Assessment of chlorpromazine as radiation sensitizer and protector Int J Radiat Oncol Biol Phys 34 1121–1124

    Google Scholar 

  67. AM Khan JW Birk JC Anderson et al. (2000) ArticleTitleA prospective randomized placebo-controlled double-blinded pilot study of misoprostol rectal suppositories in the prevention of acute and chronic radiation proctitis symptoms in prostate cancer patients Am J Gastroenterol 95 1961–1966

    Google Scholar 

  68. R Henriksson L Franzen B Littbrand (1992) ArticleTitlePrevention and therapy of radiation-induced bowel discomfort Scand J Gastroenterol Suppl 191 7–11

    Google Scholar 

  69. JA Martenson G Hyland CG Moertel et al. (1996) ArticleTitleOlsalazine is contraindicated during pelvic radiation therapy Int J Radiat Oncol Biol Phys 35 299–303

    Google Scholar 

  70. U Freund J Scholmerich H Siems F Kluge HE Schafer M Wannenmacher (1987) ArticleTitleSevere side effects with the application of Mesalazine (5-aminosalicylic acid) during radiotherapy Strahlenther Onkol 163 678–680

    Google Scholar 

  71. NA Talley F Chen D King M Jones NJ Talley (1997) ArticleTitleShort-chain fatty acids in the treatment of radiation proctitis Dis Colon Rectum 40 1046–1050

    Google Scholar 

  72. CA Baum WL Biddle PB Miner SuffixJr (1989) ArticleTitleFailure of 5-aminosalicylic acid enemas to improve chronic radiation proctitis Dig Dis Sci 34 758–760

    Google Scholar 

  73. J Cavcic J Turcic P Martinac et al. (2000) ArticleTitleMetronidazole in the treatment of chronic radiation proctitis Croat Med J 41 314–318

    Google Scholar 

  74. R Kochhar F Patel A Dhar et al. (1991) ArticleTitleRadiation-induced proctosigmoiditis. Prospective, randomized, double-blind controlled trial of oral sulfasalazine plus rectal steroids versus rectal sucralfate Dig Dis Sci 36 103–107

    Google Scholar 

  75. M Kennedy K Bruninga EA Mutlu J Losurdo S Choudhary A Keshavarzian (2001) ArticleTitleSuccessful and sustained treatment of chronic radiation proctitis with antioxidant vitamins E and C Am J Gastroenterol 96 1080–1084

    Google Scholar 

  76. GP Melko TF Turco TF Phelan NM Sauers (1999) ArticleTitleTreatment of radiation-induced proctitis with sucralfate enemas Ann Pharmacother 33 1274–1276

    Google Scholar 

  77. T Sasai H Hiraishi Y Suzuki H Masuyama M Ishida A Terano (1998) ArticleTitleTreatment of chronic post-radiation proctitis with oral administration of sucralfate Am J Gastroenterol 93 1593–1595

    Google Scholar 

  78. R Kochhar SK Mehta R Aggarwal A Dhar F Patel (1990) ArticleTitleSucralfate enema in ulcerative rectosigmoid lesions Dis Colon Rectum 33 49–51

    Google Scholar 

  79. R Kochhar PV Sriram SC Sharma RC Goel F Patel (1999) ArticleTitleNatural history of late radiation proctosigmoiditis treated with topical sucralfate suspension Dig Dis Sci 44 973–978

    Google Scholar 

  80. AD Stockdale A Biswas (1997) ArticleTitleLong-term control of radiation proctitis following treatment with sucralfate enemas Br J Surg 84 379–978

    Google Scholar 

  81. K Kawagoe T Kawana (1989) ArticleTitleIntravesical or intrarectal instillation of Maalox for the treatment of radiation cystitis or proctitis Nippon Gan Chiryo Gakkai Shi 24 1545–1550

    Google Scholar 

  82. SI Cook JH Sellin (1998) ArticleTitleReview article Aliment Pharmacol Ther 12 499–507

    Google Scholar 

  83. W Scheppach SU Christl HP Bartram F Richter H Kasper (1997) ArticleTitleEffects of short-chain fatty acids on the inflamed colonic mucosa Scand J Gastroenterol Suppl 222 53–57

    Google Scholar 

  84. P Vernia PL Fracasso V Casale et al. (2000) ArticleTitleTopical butyrate for acute radiation proctitis Lancet 356 1232–1235

    Google Scholar 

  85. R al-Sabbagh FA Sinicrope JH Sellin Y Shen L Roubein (1996) ArticleTitleEvaluation of short-chain fatty acid enemas Am J Gastroenterol 91 1814–1816

    Google Scholar 

  86. A Pinto P Fidalgo M Cravo et al. (1999) ArticleTitleShort chain fatty acids are effective in short-term treatment of chronic radiation proctitis Dis Colon Rectum 42 788–795

    Google Scholar 

  87. C Plafki UM Carl M Glag KA Hartmann (1998) ArticleTitleThe treatment of late radiation effects with hyperbaric oxygenation (HBO) Strahlenther Onkol 174 66–68

    Google Scholar 

  88. J Charneau G Bouachour B Person P Burtin J Ronceray J Boyer (1991) ArticleTitleSevere hemorrhagic radiation proctitis advancing to gradual cessation with hyperbaric oxygen Dig Dis Sci 36 373–375

    Google Scholar 

  89. DC Warren P Feehan JB Slade PE Cianci (1997) ArticleTitleChronic radiation proctitis treated with hyperbaric oxygen Undersea Hyperb Med 24 181–184

    Google Scholar 

  90. T Kitta N Shinohara H Shirato H Otsuka T Koyanagi (2000) ArticleTitleThe treatment of chronic radiation proctitis with hyperbaric oxygen in patients with prostate cancer BJU Int 85 372–374

    Google Scholar 

  91. TC Woo D Joseph H Oxer (1997) ArticleTitleHyperbaric oxygen treatment for radiation proctitis Int J Radiat Oncol Biol Phys 38 619–622

    Google Scholar 

  92. UM Carl D Peusch-Dreyer T Frieling G Schmitt KA Hartmann (1998) ArticleTitleTreatment of radiation proctitis with hyperbaric oxygen Strahlenther Onkol 174 482–483

    Google Scholar 

  93. RB Brown (1969) ArticleTitleA method of management of inoperable carcinoma of the bladder Med J Aust 1 23–24

    Google Scholar 

  94. E Rubinstein T Ibsen RB Rasmussen E Reimer BL Sorensen (1986) ArticleTitleFormalin treatment of radiation-induced hemorrhagic proctitis Am J Gastroenterol 81 44–45

    Google Scholar 

  95. JA Myers J Mall A Doolas SM Jakate TJ Saclarides (1997) ArticleTitleAbsorption kinetics of rectal formalin instillation World J Surg 21 886–889

    Google Scholar 

  96. JA Myers EF Hollinger JW Mall SM Jakate A Doolas TJ Saclarides (1998) ArticleTitleMechanical, histologic, and biochemical effects of canine rectal formalin instillation Dis Colon Rectum 41 153–158

    Google Scholar 

  97. BM Biswal P Lal GK Rath NK Shukla BK Mohanti S Deo (1995) ArticleTitleIntrarectal formalin application, an effective treatment for grade III haemorrhagic radiation proctitis Radiother Oncol 35 212–215

    Google Scholar 

  98. TJ Saclarides DG King JL Franklin A Doolas (1996) ArticleTitleFormalin instillation for refractory radiation-induced hemorrhagic proctitis Dis Colon Rectum 39 196–199

    Google Scholar 

  99. B Roche R Chautems MC Marti (1996) ArticleTitleApplication of formaldehyde for treatment of hemorrhagic radiation-induced proctitis World J Surg 20 1092–1095

    Google Scholar 

  100. M Yegappan YH Ho D Nyam A Leong KW Eu C Seow (1998) ArticleTitleThe surgical management of colorectal complications from irradiation for carcinoma of the cervix Ann Acad Med Singapore 27 627–630

    Google Scholar 

  101. SF Counter DP Froese MJ Hart (1999) ArticleTitleProspective evaluation of formalin therapy for radiation proctitis Am J Surg 177 396–398

    Google Scholar 

  102. F Seow-Choen HS Goh KW Eu YH Ho SK Tay (1993) ArticleTitleA simple and effective treatment for hemorrhagic radiation proctitis using formalin Dis Colon Rectum 36 135–138

    Google Scholar 

  103. V Mathai F Seow-Choen (1995) ArticleTitleEndoluminal formalin therapy for haemorrhagic radiation proctitis Br J Surg 82 190–138

    Google Scholar 

  104. AJ Pikarsky B Belin J Efron EG Weiss JJ Nogueras SD Wexner (2000) ArticleTitleComplications following formalin installation in the treatment of radiation induced proctitis Int J Colorectal Dis 15 96–99

    Google Scholar 

  105. V Maunoury JM Brunetaud A Cortot (1991) ArticleTitleBipolar electrocoagulation treatment for hemorrhagic radiation injury of the lower digestive tract Gastrointest Endosc 37 492–493

    Google Scholar 

  106. D Fuentes R Monserat AM Isern et al. (1993) ArticleTitleColitis due to radiation G E N 47 165–167

    Google Scholar 

  107. AC Fantin J Binek WR Suter C Meyenberger (1999) ArticleTitleArgon beam coagulation for treatment of symptomatic radiation-induced proctitis Gastrointest Endosc 49 515–518

    Google Scholar 

  108. RA Silva AJ Correia LM Dias HL Viana RL Viana (1999) ArticleTitleArgon plasma coagulation therapy for hemorrhagic radiation proctosigmoiditis Gastrointest Endosc 50 221–224

    Google Scholar 

  109. W Tam J Moore M Schoeman (2000) ArticleTitleTreatment of radiation proctitis with argon plasma coagulation Endoscopy 32 667–672

    Google Scholar 

  110. M Kaassis E Oberti P Burtin J Boyer (2000) ArticleTitleArgon plasma coagulation for the treatment of hemorrhagic radiation proctitis Endoscopy 32 673–676

    Google Scholar 

  111. A Rolachon E Papillon J Fournet (2000) ArticleTitleIs argon plasma coagulation an efficient treatment for digestive system vascular malformation and radiation proctitis? Gastroenterol Clin Biol 24 1205–1210

    Google Scholar 

  112. S Smith K Wallner JA Dominitz et al. (2001) ArticleTitleArgon plasma coagulation for rectal bleeding after prostate brachytherapy Int J Radiat Oncol Biol Phys 51 636–642

    Google Scholar 

  113. JJ Tjandra S Sengupta (2001) ArticleTitleArgon plasma coagulation is an effective treatment for refractory hemorrhagic radiation proctitis Dis Colon Rectum 44 1759–1765

    Google Scholar 

  114. S Taieb A Rolachon JC Cenni et al. (2001) ArticleTitleEffective use of argon plasma coagulation in the treatment of severe radiation proctitis Dis Colon Rectum 44 1766–1771

    Google Scholar 

  115. JG Taylor JA Disario DJ Bjorkman (2000) ArticleTitleKTP laser therapy for bleeding from chronic radiation proctopathy Gastrointest Endosc 52 353–357

    Google Scholar 

  116. JG Taylor JA DiSario KN Buchi (1993) ArticleTitleArgon laser therapy for hemorrhagic radiation proctitis Gastrointest Endosc 39 641–644

    Google Scholar 

  117. C Barbatzas GM Spencer SM Thorpe LR Sargeant SG Bown C Carbatzas (1996) ArticleTitleNd Endoscopy 28 497–500

    Google Scholar 

  118. TJ Alexander RM Dwyer (1988) ArticleTitleEndoscopic Nd:YAG laser treatment of severe radiation injury of the lower gastrointestinal tract: long-term follow-up Gastrointest Endosc 34 407–411

    Google Scholar 

  119. JJ O’Connor (1989) ArticleTitleArgon laser treatment of radiation proctitis Arch Surg 124 749–411

    Google Scholar 

  120. G Triadafilopoulos M Sarkisian (1990) ArticleTitleDilatation of radiation-induced sigmoid stricture using sequential Savary-Guilliard dilators Dis Colon Rectum 33 1065–1067

    Google Scholar 

  121. MR Yates SuffixIII TH Baron (1999) ArticleTitleTreatment of a radiation-induced sigmoid stricture with an expandable metal stent Gastrointest Endosc 50 422–426

    Google Scholar 

  122. A Luck P Chapuis G Sinclair J Hood (2001) ArticleTitleEndoscopic laser stricturotomy and balloon dilatation for benign colorectal strictures Aust N Z J Surg 71 594–597

    Google Scholar 

  123. S San Martin J Arraztoa C Trujillo (1995) ArticleTitleColoanal anastomosis (Parks operation) in the treatment of acute radiation rectitis Rev Med Chil 123 321–325

    Google Scholar 

  124. MO von Flue LP Degen C Beglinger FH Harder (1996) ArticleTitleThe ileocecal reservoir for rectal replacement in complicated radiation proctitis Am J Surg 172 335–340

    Google Scholar 

  125. AN Thompson M Levitt (2000) ArticleTitleColonic J pouch reconstruction of the radiation-damaged neorectum Aust N Z J Surg 70 560–562

    Google Scholar 

  126. AE Cram NW Pearlman PR Jochimsen (1977) ArticleTitleSurgical management of complications of radiation-injured gut Am J Surg 133 551–553

    Google Scholar 

  127. M Stuart DG Failes MJ Killingback C De Luca (1980) ArticleTitleIrradiation injuries of the large intestine Dis Colon Rectum 23 94–97

    Google Scholar 

  128. JC Russell JP Welch (1979) ArticleTitleOperative management of radiation injuries of the intestinal tract Am J Surg 137 433–442

    Google Scholar 

  129. SA Cooke NG de Moor (1981) ArticleTitleThe surgical treatment of the radiation-damaged rectum Br J Surg 68 488–492

    Google Scholar 

  130. HH Kimose L Fischer N Spjeldnaes P Wara (1989) ArticleTitleLate radiation injury of the colon and rectum-surgical management and outcome Dis Colon Rectum 32 684–689

    Google Scholar 

  131. VE Pricolo PC Shellito (1994) ArticleTitleSurgery for radiation injury to the large intestine Dis Colon Rectum 37 675–684

    Google Scholar 

  132. RB Galland J Spencer (1979) ArticleTitleSurgical aspects of radiation injury to the intestine Br J Surg 66 135–138

    Google Scholar 

  133. ME Lucarotti RA Mountford DC Bartolo (1991) ArticleTitleSurgical management of intestinal radiation injury Dis Colon Rectum 34 865–869

    Google Scholar 

  134. JC Gazet (1985) ArticleTitleParks’ coloanal pull-through anastomosis for severe, complicated radiation proctitis Dis Colon Rectum 28 110–114

    Google Scholar 

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    1. M. J. Johnston M.B.B.S., F.R.A.C.S.
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    2. G. M. Robertson M.B.Ch.B., F.R.A.C.S.
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    3. F. A. Frizelle M.B.Ch.B., M.Med.Sci., F.R.A.C.S.
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    Johnston, M.J., Robertson, G.M. & Frizelle, F.A. Management of Late Complications of Pelvic Radiation in the Rectum and Anus. Dis Colon Rectum 46, 247–259 (2003). https://doi.org/10.1007/s10350-004-6530-4

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