[Surgical management of left colon and rectal radiation injuries (author's transl)]. / Traitement chirurgical des radiolésions du colon gauche et du rectum.

ABSTRACT

A. First of all, we can affirm after the analysis of 132 records the predominance of gynecologic cancers and the frequent responsibility of medical associations in the determinism of advanced radiation injuries of colon and rectum; the typically variable appearence of these injuries with an usual delay going from 6 months to a year and limits from 2 months to 35 years; the difficulty of diagnosis between radiation injurie and recurrence of cancer especially in case of fistula and the severe forecost in case of cancer radiation injurie association. B. The surgical management exist only for non-indications and failures of medical treatment; the one stage resection with end to end anastomosis will be made exclusively on advanced, therefore non evolving and limited injuries; in most cases, the multiple stage resection must be preferred first derivation in selected part (sigmoid or transverse colon) and secondary resection in healthy area; as regards the closure of colostomy, it must never occur before a 6 months delay and anastomosis radiologic check.