Efficacy and safety of argon plasma coagulation in the management of extensive chronic radiation proctitis after pelvic radiotherapy for cervical carcinoma

Sudha, Shyama Prem; Dharanipragada, Kadambari

doi:10.1007/s00384-017-2859-8

Cited by 10 publications

(14 citation statements)

References 10 publications

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“…RP is a relatively common and potentially devastating consequence of modern radiation therapy (3, 7). It can be classified as acute or chronic depending on the temporal relationship to the course of radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…Radiation proctitis (RP) is a serious complication seen in patients who have received irradiation during treatment for tumors located in the pelvis. The development of this condition varies with the dose of radiation, the delivery method, and the organ being radiated, ultimately resulting in an incidence of chronic RP in nearly 5% of patients (1–3).…”

Section: Introductionmentioning

confidence: 99%

“…Treatment doses less than 45 Gy usually cause few side effects. However, the dosage range for most treatments, which is generally between 45 and 70 Gy, can lead to more complications (1–4). Even higher doses of radiotherapy can result in collateral damage to surrounding organs in the field of radiation.…”

Section: Introductionmentioning

confidence: 99%

“…Various medical strategies like steroid sucralfate enemas, antibiotics, 5-aminosalicylic acid derivatives, probiotics, antioxidants, formalin instillation, and hyperbaric oxygen are available for the treatment with variable efficacies (1–3). More invasive treatments including endoscopic-based, focally ablative interventions such as bipolar cautery, argon laser, radiofrequency ablation, or argon plasma coagulation (APC) are also available (1, 3). Currently, there is no gold standard available for the treatment of chronic RP (5).…”

Section: Introductionmentioning

confidence: 99%

“…Currently, there is no gold standard available for the treatment of chronic RP (5). Some therapies have shown only mild efficacy, but others present a promising option for practitioners (1, 3).…”

Section: Introductionmentioning

confidence: 99%

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Rubber Band Ligation of Hemorrhoids is often a Necessary Complement in the Management of Hemorrhagic Radiation Proctitis

Robles

Young

2019

Scand J Surg

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Background: Management of radiation proctitis presents a treatment challenge. Limited data exist on the management of symptomatic hemorrhoids in radiated patients. This study aims to present a practical approach to the management of radiation proctitis, particularly in patients with synchronous hemorrhoids. Methods: A total of 52 consecutive cases of radiation proctitis managed between September 1999 and October 2017 were retrospectively reviewed. The primary treatment was formalin application, plus rubber band ligation in conjunction with formalin when hemorrhoids were a significant component of bleeding, and occasionally argon plasma coagulation. Results: The primary indication for radiotherapy was for the treatment of prostate cancer (71%), anal squamous cell carcinoma (10%), and gynecological malignancies (18%). More than half of the patients (52%) presented with radiation proctitis and concomitant internal hemorrhoids. The hemorrhoids were managed with rubber band ligation (56%) and stapled hemorrhoidectomy (7%), at the same procedure as formalin application. At a median follow-up of 12 months, no recurrent rectal bleeding occurred, and no further treatment was needed for most patients. One patient experienced a short period of perianal pain, which was treated with analgesics. Conclusion: Formalin application has consistently demonstrated an excellent cure rate and safety profile comparable with the published results as a primary treatment for radiation proctitis. The prolapse of irradiated mucosa over the internal hemorrhoids appears to exacerbate bleeding. Local hemorrhoid treatment is often required as an adjunct in the management of these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Rubber Band Ligation of Hemorrhoids is often a Necessary Complement in the Management of Hemorrhagic Radiation Proctitis

Robles

Young

2019

Scand J Surg

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Inflammatory bowel disease–like conditions: radiation injury of the gut

Shen

2020

Atlas of Endoscopy Imaging in Inflammatory Bowel Disease

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Devices for endoscopic hemostasis of nonvariceal GI bleeding (with videos)

et al. 2019

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Background Endoscopic intervention is often the first line of therapy for GI nonvariceal bleeding. Although some of the devices and techniques used for this purpose have been well studied, others are relatively new, with few available outcomes data. Methods In this document, we review devices and techniques for endoscopic treatment of nonvariceal GI bleeding, the evidence regarding their efficacy and safety, and financial considerations for their use. Results Devices used for endoscopic hemostasis in the GI tract can be classified into injection devices (needles), thermal devices (multipolar/bipolar probes, hemostatic forceps, heater probe, argon plasma coagulation, radiofrequency ablation, and cryotherapy), mechanical devices (clips, suturing devices, banding devices, stents), and topical devices (hemostatic sprays). Conclusions Endoscopic evaluation and treatment remains a cornerstone in the management of nonvariceal upper- and lower-GI bleeding. A variety of devices is available for hemostasis of bleeding lesions in the GI tract. Other than injection therapy, which should not be used as monotherapy, there are few compelling data that strongly favor any one device over another. For endoscopists, the choice of a hemostatic device should depend on the type and location of the bleeding lesion, the availability of equipment and expertise, and the cost of the device.

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Efficacy and safety of argon plasma coagulation in the management of extensive chronic radiation proctitis after pelvic radiotherapy for cervical carcinoma

Abstract: Argon plasma coagulation is a safe, well tolerated and effective treatment option in extensive chronic radiation proctitis which is refractory to medical management.

Cited by 10 publications

References 10 publications

Rubber Band Ligation of Hemorrhoids is often a Necessary Complement in the Management of Hemorrhagic Radiation Proctitis

Rubber Band Ligation of Hemorrhoids is often a Necessary Complement in the Management of Hemorrhagic Radiation Proctitis

Inflammatory bowel disease–like conditions: radiation injury of the gut

Devices for endoscopic hemostasis of nonvariceal GI bleeding (with videos)

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