Letter to the editor concerning: Hawkins M, Billingham R, Bastawrous A. Hemorrhoid management in patients with radiation proctitis. Int J Colorectal Dis. 2012 Jun 20. [Epub ahead of print].

摘要

Patients who received curative radiotherapy for pelvic organ malignancies will eventually face complications such as incontinence and proctitis [1]. In addition, there is a potential threat for severe complications like a rectourethral fistula after "light" surgical intervention such as biopsies or rubber band ligation in preirradiated tissue. In this context, we were horrified by the results of Hawkins et al.: 55 % of the respondents "hoped" that the treatment of the proctitis would solve all the patient's problems, but 43 % used rubber band ligation, haemorrhoidectomy and sclerosing injection to treat "haemorrhoidal" symptoms. The authors reported that only 28 % had more than ten cases of radiation proctitis per year. It would be interesting to know what these somewhat more experienced surgeons would have done concerning haemorrhoidal therapy.