Three cases using with pull-through procedure for radiation-injured rectum

Instead of sigmoid colostomy, which has been accepted as the conventional treatment for the radiation-injured rectum resulting from radiation therapy for cervical uterine cancer, we tried a pull-through procedure with resection of the affected rectal segment. The following three conditions were indications for this operation: 1) No recurrence of initial malignancy in the pelvis and no distant metastasis. 2) No radiation-injured segments in the upper descending colon or in a wide area of small intestine. 3) No disfunction of the anal sphincter because of the advanced age or chronic anal diseases. Three patients, 55- 77- and 60-year-old females, who had anal bleeding, fecal discomfort and rectal stricture over one year after radiation therapy of more than 8,000 rad underwent this operation. They have had no evidence of relapse or other complications after operation over 5 months for the first patient and over 36 months and 42 months respectively for the second and third patient. As a result, this procedure seemed to be the most adequate operation for radiation-injured rectum. (author)