Abstract
aq 66-year-old man complaining of abdominal fullness and lower abdominal pain was admitted to the hospital because of intestinal lobstruction, There were histories of radical left nephro-ureterectomy for a carcinoma of the left ureter 6 years before, and radiation therapy for recurrence in the urinary bladder one year after the operation. On admission, contrast enema, CT and colon endoscopy examination revealed a whole-circumference stenosis and ulcer from the sigmoid colon to Rs portion of the rectum. Under a diagnosis of radiation proctitis, an operation was successfully performed with low anterior resection. The patient has been well with no symptoms after operation.
In a review of 273 operated cases of radiation proctitis reported in Japan during the last one decade, spincter saving operation which was employed in this case was rarely performed, namely, low anterior resection was done only in 4 cases, and pull through excision in 7 cases. Radiation proctitis is essentially ischemic disease with vessel changes, therefore we believe that in addition to the routine studies, preoperative angiography and intraoperative examination by frozen section at the excisional edge are necessary.
It is also emphasized to perform spincter saving operations as much as possible and to improve the quality of life for the patients.
