Assessment of gastrointestinal blood flow with laser Doppler flowmetry in patients with chronic radiation injury.

Laser Doppler flowmetry was used for pre- and intraoperative assessment of gastrointestinal blood flow and vascular damage in eight patients with late radiation injury of the gastrointestinal tract. The flowmeter recordings were compared with reference values previously obtained in unaffected tissue from corresponding gastrointestinal sites. Marked reduction of blood flow was demonstrated in macroscopic areas of radiation injury in all eight patients. Five also showed varying degrees of disturbed blood flow in adjacent macroscopically normal bowel segments with histologically varying severity of radiation injury. In a ninth patient radiation injury was clinically suspected but could not be demonstrated with laser Doppler flowmetry or histologically. The extent of radiation injury often is underestimated from clinical signs, and laser Doppler flowmetry during surgical treatment of late radiation injury to the gastrointestinal tract provides substantial information concerning the extent of vascular damage.