Document Detail


Preoperative radiation therapy produces an early and persistent reduction in colorectal anastomotic blood flow.
MedLine Citation:
PMID:  1434596     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Preoperative external beam radiation therapy (RT) is an increasingly popular form of adjunct therapy for rectal cancer; however, little is known about its effects on healing of colorectal anastomoses. We serially evaluated colorectal anastomotic healing following moderate dose RT. Twenty-four adult female pigs were administered 4250 centiGrays (cGy) of external beam pelvic RT over 4 weeks followed by rectosigmoid resection with handsewn or circular stapled anastomosis. Groups of animals were then sacrificed at 5, 11, 60, and 120 days postoperatively. A control group (N = 24) was studied similarly but not irradiated. Perianastomotic blood flow was measured using laser doppler velocimetry at each time interval. Nonirradiated anastomoses demonstrated significantly higher blood flows compared to irradiated anastomotic segments at each study interval. In addition, early (Days 5 and 11) postoperative gross inflammatory scores and microscopic inflammatory score (all intervals) were significantly higher for irradiated animals. Anastomotic complications were more frequent in irradiated animals (7/24) vs controls (2/24, P < 0.05). These results indicate that a preoperative dose of 4250 cGy results in an early and persistent decrease in colorectal mural blood flow independent of anastomotic technique. This is the first experimental study which attempts to quantitate the effects of preoperative pelvic radiation therapy on anastomotic blood flow.
Authors:
J W Milsom; A Senagore; R K Walshaw; U V Mostosky; P Wang; W Johnson; I H Chaudry
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of surgical research     Volume:  53     ISSN:  0022-4804     ISO Abbreviation:  J. Surg. Res.     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1992-12-04     Completed Date:  1992-12-04     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  0376340     Medline TA:  J Surg Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  464-9     Citation Subset:  IM    
Affiliation:
Ferguson Clinic, Department of Surgical Research, Michigan State University, East Lansing.
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical
Animals
Blood Flow Velocity / radiation effects
Colon / blood supply*,  radiation effects,  surgery*
Female
Inflammation
Postoperative Complications
Preoperative Care*
Radiotherapy / adverse effects*
Rectum / blood supply*,  radiation effects,  surgery*
Swine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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