Year 2004 / Volume 96 / Number 11
Original
Efficacy and safety of argon plasma coagulation for the treatment of hemorrhagic radiation proctitis

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C. de la Serna Higuera,M. I.Martín Arribas, S. J. Rodríguez Gómez, A. Pérez Villoria, J.MartínezMoreno and A. Betancourt González

Abstract
Objective: to evaluate the efficacy, safety and medium-/longterm clinical course of patients undergoing endoscopic treatment
with argon plasma coagulation for hemorrhagic radiation proctopathy.
Design: descriptive, retrospective study with medium- and long-term follow-up.

Patients, material and methods: ten patients were treated with argon plasma coagulation for hemorrhagic radiation proctopathy between July 1998 and February 2003. Inclusion criteria
were: evidence of chronic rectal bleeding, consistent endoscopic findings, and absence of any other cause of hematochezia after a
comprehensive ano-rectal examination and complete colonoscopy.
The equipment used was a standard colonoscope, an argon delivery unit, an argon plasma coagulation probe 1.5 mm in internal diameter, and a high-frequency electrosurgical generator. Consecutive
treatment sessions were programmed whenever it was considered necessary until all mucosal lesions had been treated.
Clinical and evolutive follow-up was performed with a focus on tolerance, efficacy, and potential argon plasma coagulation-related complications. Data were updated by personal or telephonic interview.

Results: in all patients, chronic rectal bleeding stopped after the last treatment session. The mean number of treatment sessions to stop symptoms was 1.7. Mean follow-up was 31.1 months. All sessions were well tolerated, similarly to standard rectoscopy.
In one case a recurrence of rectal bleeding was observed four months later, which required two repeat sessions. Four patients were anemic at inclusion. Three of them reported a resolved
anemia at the end of the study. No delayed argon plasma coagulation-related complications such us ulcers or strictures were seen.

Conclusions: argon plasma coagulation appears to be a useful, effective and safe treatment for rectal bleeding resulting from chronic radiation proctitis when compared to standard medical and endoscopic treatments. These successful outcomes seem to
persist even after long-term follow-up.
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C. de la Serna Higuera,M. I.Martín Arribas, S. J. Rodríguez Gómez, A. Pérez Villoria, J.MartínezMoreno and A. Betancourt González. Efficacy and safety of argon plasma coagulation for the treatment of hemorrhagic radiation proctitis. 0


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