Does external beam radiation therapy to the pelvis portend worse ileal pouch outcomes? An international multi-institution collaborative study.
Colorectal Dis
; 21(2): 219-225, 2019 02.
Article
em En
| MEDLINE
| ID: mdl-30411480
ABSTRACT
AIM:
Short-term morbidity and long-term functional outcome of patients with an ileal pouch-anal anastomosis (IPAA) exposed to pelvic external beam radiation therapy (EBRT) remains unknown. We report the largest series to date regarding the effects of pelvic EBRT on (i) 30-day postoperative outcomes; and (ii) long-term functional outcome following IPAA.METHOD:
A retrospective chart review was conducted of patients who received EBRT before or after IPAA between 1980 and 2017 across three international inflammatory bowel disease referral centres.RESULTS:
Nineteen patients were included. Indications for EBRT were rectal adenocarcinoma (n = 13), prostate adenocarcinoma (n = 4) or anal squamous cell carcinoma (ASCC) (n = 2). EBRT was given prior to IPAA in 12 (63%) patients and after IPAA in seven (37%). In EBRT before IPAA, patients had a median of 5 (range 4-8) daytime bowel movements, 1 (range 0-5) night-time bowel movement, no daytime incontinence, and only one patient used pads at a median follow up of 25 (range 11-163) months; one patient underwent pouch excision 15 months after IPAA. In EBRT after IPAA, patients reported a median of 8 (range 5-10) daytime and 2 (range 0-5) night-time bowel movements, 80% had either daytime or night-time incontinence and 80% used pads at a median follow up of 90 (range 25-315) months.CONCLUSION:
Pelvic EBRT administered prior to IPAA is associated with acceptable long-term function outcome. However, when pelvic EBRT is given to an IPAA in situ, most patients experience poor long-term pouch function without pouch failure.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Próstata
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Neoplasias Retais
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Proctocolectomia Restauradora
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Incontinência Fecal
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article