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In Reply.—I agree with the contention that preoperative radiation to the skin and bowel increases the morbidity for construction of intestinal stomas. In fairness to Dr Roberts, almost all of the patients in the gynecologic oncology group had received preoperative radiation therapy. However, of the 17 patients in this group in whom stomal complications developed, 11 (65%) had necrosis of their stomas. Surely, the disproportionate incidence of this serious complication cannot be attributed to the effects of radiation therapy alone. It was not my intention in presenting these data to point an accusing finger at any particular group of specialists. Rather, I hoped to help make us all aware of how important attention to detail is in the construction of intestinal stomas, since many of these complications are preventable.
PEARL RK. Early Local Complications From Intestinal Stomas-Reply. Arch Surg. 1987;122(1):120. doi:10.1001/archsurg.1987.01400130125025