Long-term outcome after extensive intestinal resection for chronic radiation enteritis

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• 作者：Aurelien Amiot^a ; ^c ; ^{aurelien.amiot@bjn.aphp.fr} ; Francisca Joly^a ; ^c ; Jé ; ré ; mie H. Lefevre^b ; ^c ; Olivier Corcos^a ; ^c ; Frederic Bretagnol^b ; ^c ; Yoram Bouhnik^a ; ^c ; Yves Panis^b ; ^c ; Bernard Messing^a ; ^c
• 关键词：Chronic radiation enteritis ; Home parenteral nutrition ; Intestinal failure ; Short bowel syndrome
• 刊名：Digestive and Liver Disease
• 出版年：2013
• 出版时间：February, 2013
• 年：2013
• 卷：45
• 期：2
• 页码：110-114
• 全文大小：293 K

文摘

Introduction

Management of chronic radiation enteritis is often controversial, particularly due to the risk of short bowel syndrome.

Methods

One hundred and seven chronic radiation enteritis patients with short bowel syndrome were studied retrospectively between 1980 and 2009. Survival and home parenteral nutrition dependence rates were evaluated with univariate and multivariate analysis.

Results

The survival probabilities were 93 % , 67 % and 44.5 % at 1, 5 and 10 years, respectively. On multivariate analysis, survival was significantly decreased with residual neoplastic disease (HR = 0.21 [0.11-0.38], p < 0.001), an American Society of Anesthesiologists score >3 (HR = 0.38 [0.20-0.73], p = 0.004) and an age of chronic radiation enteritis diagnosis >60 years (HR = 0.45 [0.22-0.89], p = 0.02). The actuarial home parenteral nutrition dependence probabilities were 66 % , 55 % and 43 % at 1, 2 and 3 years, respectively. On multivariate analysis, this dependence was significantly decreased when there was a residual small bowel length >100 cm (HR = 0.35 [0.18-0.68], p = 0.002), adaptive hyperphagia (HR = 0.39 [0.17-0.87], p = 0.02) and the absence of a definitive stoma (HR = 0.48 [0.27-0.84], p = 0.01).

Conclusion

The survival of patients with diffuse chronic radiation enteritis after extensive intestinal resection was good and was mainly influenced by underlying comorbidities. Almost two-thirds of patients were able to be weaned off home parenteral nutrition.