The types and surgical treatments of complex intestinal fistula after radiotherapy for cervical cancer
10.3760/cma.j.cn113855-20220120-00042
- VernacularTitle:宫颈癌放疗后复杂型放射性肠瘘的类型、手术治疗方式及疗效的探讨
- Author:
Zhi ZHANG
1
;
Gangcheng WANG
;
Guoqiang ZHANG
;
Youcai WANG
;
Han ZHOU
;
Yingjun LIU
;
Shuzhen TIAN
;
Fang WANG
;
Hongli WANG
Author Information
1. 郑州大学附属肿瘤医院普外科 河南省肿瘤医院，郑州 450000
- Keywords:
Uterine cervival neoplasms;
Intestinal fistula;
Radiotherapy
- From:
Chinese Journal of General Surgery
2022;37(9):655-659
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the types, surgical treatments of complex intestinal fistula after radiotherapy for cervical cancer.Methods:The clinical data and treatment of 26 patients with complex intestinal fistula after radiotherapy for cervical cancer at Cancer Hospital of Zhengzhou University from Jan 2013 to Jan 2020 were reviewed .Results:Eleven patients were with recto-vaginal fistula, 1 patient with sigmoido-vesical fistula, 5 patients with combined rectal, vaginal and vesical fistula, 7 patients with low rectal fistula and peripheral infection, and 2 patients with ileo-vaginal stump fistula after radical resection of cervical cancer and adjuvant radiotherapy. All patients were underwent the surgery, including 9 patients for total pelvic or posterior pelvic resection, 6 patients for rectum or sigmoid colectomy, bladder or vaginal repair, 7 patients were done for Hartmann surgery, and 1 patient underwent segmental resection, enteroanastomosis and vaginal repair, 3 patients for transverse colostomy or proximal ileostomy. No major postoperative complications occurred . The symptoms of intestinal fistula in all patients were dissolved, and the perineal pain was significantly relieved in 23 patients. The symptoms of ileal fistula reccurred in 2 patients within 1 year after operation, and there was no mortality.Conclusions:The rectal related intestinal fistula is the most common complex intestinal fistula after radical radiotherapy for cervical cancer. The point of surgical treatment is to remove the diseased rectum or ileum.
