中国实用外科杂志2025，Vol.45Issue(3)：279-284,6.DOI:10.19538/j.cjps.issn1005-2208.2025.03.08
放射性肠损伤合并肠瘘的治疗原则与策略
Treatment principles and strategies for radiation intestinal injury complicated with intestinal fistula
摘要
Abstract
Radiotherapy is a common treatment for pelvic malignancies,but cumulative radiation doses may lead to radiation-induced intestinal injury(RII).Enteric fistula,a severe complication of RII,significantly impacts patients'quality of life.Due to the distinct pathophysiological mechanisms of acute and chronic RII,stage-specific therapeutic strategies should be adopted for enteric fistula.For acute RII with enteric fistula,the guiding principle should be"damage control",prioritizing rapid infection management through minimally invasive interventions.In chronic RII with enteric fistula,definitive resection of the radiation-injured"culprit lesions"is the primary goal.Since RII-associated enteric fistula often involves adjacent pelvic organs,a holistic pelvic perspective combined with multidisciplinary collaboration is essential for comprehensive evaluation and individualized treatment planning.Enterostomy diversion plays a pivotal role in staged surgical management and its reasonable application can provide a window for secondary definitive resection.For patients with multi-visceral fistulas or complex fistulas,multi-visceral resection or total pelvic exenteration may ultimately be required.关键词
放射性肠损伤/肠瘘/损伤控制/确定性切除/多学科协作Key words
radiation-induced intestinal injury/intestinal fistula/damage control/definitive resection/multidisciplinary collaboration分类
医药卫生引用本文复制引用
秦启元,李至杰,马腾辉..放射性肠损伤合并肠瘘的治疗原则与策略[J].中国实用外科杂志,2025,45(3):279-284,6.基金项目
National Natural Science Foundation of China(General Program,No.82473561) （General Program,No.82473561）
The Sixth Affiliated Hospital of Sun Yat-sen University Clinical Research"1010"Program[No.1010PY(2022)-09] 国家自然科学基金面上项目(No.82473561) （2022）
中山大学附属第六医院"1010"计划项目[No.1010PY(2022)-09] （2022）
