COLOANAL ANASTOMOSIS (PARKS OPERATION) IN THE TREATMENT OF SEVERE RADIATION RECTITIS

Aim: To asses inmediate and late results of Parks operation in the tre atment of severe radiation rectitis. Patients and method Retrospective review of clinical histories of 35 patients with uterine cervical can cer, 5 with endometrial cancer and one with vaginal cancer that receiv ed radiotherapy. Two years as a mean after radiotherapy 14 women had r ectal bleeding, 19 fistulae, 7 stenosis and 1 a rectal ulceration. All were initially treated with a discharge colostomy and after a mean in terval of 1.6 years, a Parks operation was performed. Results: One pat ient died after surgery (2.4%) due to peritonitis and sepsis. Early su rgical complications were necrosis of descended colon in 5 intra-abdom inal abscess in 1, splenic rupture in 2 and postoperative bleeding in 1. Colostomy was closed in 37 patients three months after surgery. Dur ing late follow up (ranging from 3 to 64 months) rectal continence has been assesed as good in 30 patients, fair in 5 and bad in 2. Three wo men required a new colostomy. Conclusion: Parks operation is a viable therapeutic alternative for severe radiation rectitis.