Original Article
The types and surgical treatments of complex intestinal fistula after radiotherapy for cervical cancer
Zhang Zhi, Wang Gangcheng, Zhang Guoqiang, Wang Youcai, Zhou Han, Liu Yingjun, Tian Shuzhen, Wang Fang, Wang Hongli
Published 2022-09-25
Cite as Chin J Gen Surg, 2022, 37(9): 655-659. DOI: 10.3760/cma.j.cn113855-20220120-00042
Abstract
ObjectiveTo investigate the types, surgical treatments of complex intestinal fistula after radiotherapy for cervical cancer.
MethodsThe 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 .
ResultsEleven 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.
ConclusionsThe 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.
Key words:
Uterine cervival neoplasms; Intestinal fistula; Radiotherapy
Contributor Information
Zhang Zhi
Department of General Surgery, Cancer Hospital of Zhengzhou University, He'nan Provincial Cancer Hospital, Zhengzhou 450000, China
Wang Gangcheng
Department of General Surgery, Cancer Hospital of Zhengzhou University, He'nan Provincial Cancer Hospital, Zhengzhou 450000, China
Zhang Guoqiang
Department of General Surgery, Cancer Hospital of Zhengzhou University, He'nan Provincial Cancer Hospital, Zhengzhou 450000, China
Wang Youcai
Department of General Surgery, Cancer Hospital of Zhengzhou University, He'nan Provincial Cancer Hospital, Zhengzhou 450000, China
Zhou Han
Department of General Surgery, Cancer Hospital of Zhengzhou University, He'nan Provincial Cancer Hospital, Zhengzhou 450000, China
Liu Yingjun
Department of General Surgery, Cancer Hospital of Zhengzhou University, He'nan Provincial Cancer Hospital, Zhengzhou 450000, China
Tian Shuzhen
Department of Gynecological Oncology, Cancer Hospital,Zhengzhou University, He' nan Provincial Cancer Hospital, Zhengzhou 450000, China
Wang Fang
Department of General Surgery, Cancer Hospital of Zhengzhou University, He'nan Provincial Cancer Hospital, Zhengzhou 450000, China
Wang Hongli
Department of General Surgery, Cancer Hospital of Zhengzhou University, He'nan Provincial Cancer Hospital, Zhengzhou 450000, China