XXXX of the rectum: evaluation of surgical treatment.

@entity1 @entity5 @entity4272 @entity1161 @entity260 @entity292 @entity850 @entity204 @entity130
One hundred four @entity1 , 80 @entity1 and 24 @entity1 , with @entity1161 following treatment for gynecologic and @entity5 were studied. In 50 @entity1 , the @entity130 was treated surgically; 54 @entity1 were treated conservatively. The age and sex distributions were the same in each group. In 63 @entity1 , symptoms developed one month to one year after radiotherapy. The longest latent interval was 17 years. Of the 50 surgical @entity1 , 23 had associated small bowel injury. The indications for surgery for the @entity130 were 1) @entity4272 unresponsive to conservative measures in 14 @entity1 , 2) @entity850 or @entity292 or both in 32, and 3) rectosigmoid perforation in four. Forty-one @entity1 had external diversions. Eleven had intestinal continuity restored; six of the 11 had required the stoma for @entity4272 unresponsive to medical measures. Nineteen @entity1 did not undergo colostomy closure, although symptoms wer greatly improved. Diversion alone was insufficient treatment in the remaining 11 @entity1 . Twenty-six @entity1 died. The 12 @entity204 in the surgical group comprised four due to residual malignancy, four from @entity260 , and four from unrelated causes. Of the 14 @entity204 in the nonsurgical group, 11 died of the primary malignancy and three of unrelated causes. Diversion is considered the safest form of treatment for rectovaginal fistulae, rectal strictures, and @entity4272 unresponsive to medical measures. Intestinal resection resulted in sharp rise in the morbidity and mortality rates.
