Safety and effectiveness analysis of proximal extended excision Bacon (PE-Bacon) in the treatment of late complications of radiation-induced rectal injury
[Objectives] To explore the safety and effectiveness of PE-Bacon for late complications of radiation-induced late rectal injury(RLRI). [Methods] A retrospective analysis was conducted on the clinical and follow-up data of 158 patients who underwent PE-Bacon for late complications of RLRI at the Sixt...
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| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | zho |
| Published: |
Editorial Office of Journal of Colorectal & Anal Surgery
2025-02-01
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| Series: | 结直肠肛门外科 |
| Subjects: | |
| Online Access: | https://jzcgmwk.cbpt.cnki.net/WKD/WebPublication/paperDigest.aspx?paperID=a15e2387-7093-4597-9a56-ee286bf8d00d |
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| Summary: | [Objectives] To explore the safety and effectiveness of PE-Bacon for late complications of radiation-induced late rectal injury(RLRI). [Methods] A retrospective analysis was conducted on the clinical and follow-up data of 158 patients who underwent PE-Bacon for late complications of RLRI at the Sixth Affiliated Hospital of Sun Yat-sen University and Dongguan First Hospital Affiliated to Guangdong Medical University from September 2012 to October 2024. Surgical indicators (surgical approach, operative time, intraoperative blood loss, intraoperative blood transfusion), postoperative complications, stoma reversal, and defecation function after stoma reversal were collected and analyzed. Results Among the 158 patients, 148 underwent laparoscopic surgery, 9 underwent open surgery, and 1 was converted to open surgery, and 58 of them were combined with transanal endoscopic microsurgery. The median operative time was 276 (229,337) minutes, the median blood loss was 100 (50,100) mL, and 26 patients required intraoperative blood transfusion. Within 30 days postoperatively, 13 patients experienced severe complications of grade Ⅲb or higher, including 9 grade Ⅲb and 4 grade Ⅳ complications. Twenty patients required rehospitalization due to complications. One year postoperatively, symptoms of RLRI significantly improved or resolved in all patients. Stoma reversal was achieved in 75 patients, with a reversal rate of 51% (75/147) (11 patients did not reach the stoma reversal time point, i.e., 3 months or more postoperatively), and the average interval between stoma reversal and the initial surgery was (329.2±188.3) days. After stoma reversal, 8 patients had no low anterior resection syndrome (LARS), 12 had mild LARS, 46 had severe LARS, and 9 died or were lost to follow-up. Additionally, 7 patients required restoma creation due to complications after stoma reversal. [Conclusion] PE-Bacon is safe and feasible for the treatment of late complications of RLRI, with a low incidence of postoperative complications. However, measures should be taken to prevent possible severe LARS. |
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| ISSN: | 1674-0491 |