Ileal or ileocecal resection for chronic radiation enteritis with small bowel obstruction: outcome and risk factors

BackgroundThe choice of the optimum surgical procedure for chronic radiation enteritis (CRE) has not reached a consensus over the years. This study aimed to evaluate the outcomes in patients undergoing ileal or ileocecal resection for CRE and to identify predictive risk factors for postoperative complications.MethodsUnivariate and multivariate analyses of a retrospectively gathered database (2001 to 2011) were performed on a cohort of patients (N = 158) undergoing ileal or ileocecal resection for CRE obstruction at a single institution.ResultsOverall and major morbidity rates were 57.0% (90 patients) and 28.5% (45 patients), respectively. Surgical complications occurred in 20 patients (12.7%) and postoperative permanent parenteral nutrition dependence was 12.1% (12 of 99 patients). Multivariate analysis determined that an American Association of Anesthesiologists' score of III or higher, anemia, low platelet level, intraoperative transfusion, presence of radiation uropathy, and experience of surgeons were independent risk factors for Clavien-Dindo grades III to V morbidity.ConclusionsIleal or ileocecal resection for CRE has an acceptable risk of permanent intestinal failure and surgical complications. This study also provides the 1st evidence of predictive risk factors for postoperative morbidity of ileal or ileocecal resection for CRE.