Anastomosis coloanal, operación de Parks, para el tratamiento de la rectitis actínica grave / Coloanal anastomosis coloanal, Parks surgery, in the treatment of severe radiation rectitis

RESUMO

Aim: To assess inmediate and late results of Prks operation in the treatment of severe radiation rectitis. Patients and methods: Retrospective review of clinical histories of 35 patients with uterine cervical cancer, 5 with endometrial cancer and 1 with vaginal cancer that received radiotherapy. Two years as a mean after radiotherapy, 14 women had rectal bleeding, 19 fistulae, 7 stenosis and 1 rectal ulceration. All were initially treated with a discharge colostomy and after a mean interval of 1.6 years, a Parks operation was performed. Results: One patient died after surgery (2.4 percent) due to peritonitis and sepsis. Early surgical complications were necrosis of descended colon in 2, intra-abdominal sbscess in 1, splenic rupture in 1 and postoperative bleeding in 1. Colostomy was closed in 37 patients 3 months after surgery. During late follow up (ranging from 3 to 64 months) rectal continence has been assessed as good in 30 patients, fair in 5 and bad in 2. Three women required a new colostomy. Conclusion: Parks operation is a viable therapeutic alternative for severe radiation rectitis