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Successful Surgical Treatment of Intractable Post-Radiation Rectal Bleeding

Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
Gilan University of Medical Sciences, Rasht, Iran
Vascular and Endovascular Surgery, Golestan University of medical Sciences, Gorgan 1136746911, Iran
Author to whom correspondence should be addressed.
Surg. Tech. Dev. 2021, 10(1), 9125;
Received: 7 March 2021 / Revised: 29 December 2021 / Accepted: 3 January 2022 / Published: 13 January 2022


Patients will typically present symptoms of chronic post-radiation colitis and proctitis 8–12 months after finishing their treatment. Endoscopic methods play the main role the treatment of bleeding caused by post-radiation colitis and proctitis. Surgical treatment is required for remained approximately 10% of patients. Here we present a 64 year old female with metastatic breast cancer, who was referred to us for intractable rectal bleeding. Total colonoscopy and rigid rectosigmoidoscopy revealed proctitis, rectal and sigmoidal telangiectasis, multiple necrotic ulcers between 15 to 30 cm from the anal verge, and also huge ishemic ulcer with patchy necrotic areas about 10 cm from the anal verge. This abnormal irradiated part was resected and then mucosectomy of the remnant rectum, both transabdominally and transanally was done. We performed pull-through technique of normal proximal colon to anal region through the remnant rectal wall and finally did coloanal anastomosis. Diverting stoma was not made because of anastomosis in anal region. With this technique we can achieve benefits such as avoidance of harsh dissection in a frozen pelvis and its consequences, we can avoid intra-abdominal anastomosis, there is no need to a diverting stoma and, most important of all, definite bleeding control.
Keywords: radiation; proctitis; rectal bleeding; surgery radiation; proctitis; rectal bleeding; surgery

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MDPI and ACS Style

Mirzaei, R.; Mahjoubi, B.; Shoa, J.; Cheraghali, R.; Omrani, Z. Successful Surgical Treatment of Intractable Post-Radiation Rectal Bleeding. Surg. Tech. Dev. 2021, 10, 9125.

AMA Style

Mirzaei R, Mahjoubi B, Shoa J, Cheraghali R, Omrani Z. Successful Surgical Treatment of Intractable Post-Radiation Rectal Bleeding. Surgical Techniques Development. 2021; 10(1):9125.

Chicago/Turabian Style

Mirzaei, Rezvan, Bahar Mahjoubi, Jalil Shoa, Roozbeh Cheraghali, and Zahra Omrani. 2021. "Successful Surgical Treatment of Intractable Post-Radiation Rectal Bleeding" Surgical Techniques Development 10, no. 1: 9125.

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