Argon beam coagulation for treatment of symptomatic radiation-induced proctitis

Fantin, Amedeo C.; Binek, Janek; Suter, Walter; Meyenberger, Christa

doi:10.1016/s0016-5107(99)70054-4

Cited by 96 publications

(59 citation statements)

References 18 publications

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“…Three years later (10) were reported preliminary results about APC treatment of radiation-induced proctitis. The efficacy and safety of APC have been suggested in several case series (11)(12)(13)(14)(15)(16)(17). They have included from seven (11) to twenty eight patients (12), reaching a total amount of 110 patients treated in this setting.…”

Section: Discussionmentioning

confidence: 99%

“…APC is a non-touch electrocoagulation technique in which high-frequency alternating current can be delivered to the tissue by ionized gas. Several case-series reported until now (10)(11)(12)(13)(14)(15)(16)(17), have demonstrated APC like effective, safe and low cost therapeutic alternative even after unsuccesful treatment using other methods.…”

Section: Introductionmentioning

confidence: 99%

“…Esta última constituye una técnica de electrocoagulación sin contacto que emplea energía de alta frecuencia transmitida al tejido a través de gas ionizado. En las series comunicadas hasta el momento (10)(11)(12)(13)(14)(15)(16)(17), se está revelando como una alternativa terapéutica segura, eficaz y de bajo coste aun en pacientes refractarios a otro tipo de procedimientos. En nuestro país no existen series publicadas al respecto (revisión bibliográfica MEDLINE, EMBASE, Science Citation Index, Index Medicus Español 1997-2003).…”

Section: Introductionunclassified

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Efficacy and safety of argon plasma coagulation for the treatment of hemorrhagic radiation proctitis

Higuera

Arribas

Gómez

et al. 2004

Rev. esp. enferm. dig.

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionunclassified

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Efficacy and safety of argon plasma coagulation for the treatment of hemorrhagic radiation proctitis

Higuera

Arribas

Gómez

et al. 2004

Rev. esp. enferm. dig.

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“…86 In several other studies, cessation of bleeding was reported after 1 to 3 sessions of APC. [87][88][89][90][91][92] Complications of APC include rectal pain, rectal stenosis, altered bowel habits, and rectal wall injury. Reported rates of rectal ulceration leading to fistula development range from <1% to 2%.…”

Section: Argon Plasma Coagulationmentioning

confidence: 99%

Late rectal complications after prostate brachytherapy for localized prostate cancer

Phan¹,

Swanson²,

Levy³

et al. 2009

Cancer

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This review of the literature on late rectal complications after prostate brachytherapy indicated that it is a highly effective treatment modality for patients with clinically localized prostate cancer but can cause chronic radiation proctitis. The most common manifestation of chronic radiation proctitis was anterior rectal wall bleeding, which often occurred within the first 2 years after brachytherapy. It is interesting to note that the rates of late rectal morbidity appear to have declined over time, which may reflect improvements in implantation techniques and imaging. Rectal biopsy as part of the workup to evaluate rectal bleeding can lead to rectal fistula and the need for colostomy, a rare but major complication. The authors recommend 1) screening colonoscopy before brachytherapy for patients who have not had a screening colonoscopy within the preceding 3 years to rule out colorectal malignancies and, thus, facilitate conservative management should rectal bleeding occur; 2) lifestyle modifications during treatment to limit exposure of the rectum to radiation; and 3) conservative management for rectal bleeding that occurs within 2 years after brachytherapy. Prostate cancer is the leading cause of cancer in men and accounts for approximately 33% of cancer deaths among men in the US.1,2 Management options for organ-confined, low-to intermediate-risk prostate cancer include watchful waiting, radical prostatectomy, external-beam radiation therapy, and prostate brachytherapy with permanent interstitial implants. Recent improvements in radioactive seed implantation techniques have established prostate brachytherapy as a highly effective treatment modality for localized prostate cancer, with long-term local and biochemical control similar to outcomes observed after radical prostatectomy and external-beam radiation therapy. 3,4 Because prostate cancer is diagnosed

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“…El argón plasma es el sistema más utilizado en los últi-mos años por su bajo número de complicaciones (20)(21)(22)(23) y por su relativo bajo coste. Es utilizado como sistema de electrocoagulación en las lesiones vasculares.…”

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Valoración de la respuesta endoscópica al tratamiento con argón plasma en la rectitis actínica crónica

Sánchez

García-Argüelles

Cerdá³

et al. 2008

Rev. esp. enferm. dig.

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INTRODUCCIÓNLa rectitis actínica crónica es una enfermedad con una incidencia que oscila del 2 al 20% (1) en los pacientes que han recibido radioterapia como tratamiento de tumoValoración de la respuesta endoscópica al tratamiento con argón plasma en la rectitis actínica crónica Vol. 100. N.°10, pp. 619-624, 2008 Recibido: 03-06-08. Aceptado: 17-06-08. RESUMENObjetivo: valorar la mejoría endoscópica tras el tratamiento con argón plasma utilizado para el control sintomático de las rectitis actínicas crónicas.Diseño y pacientes: estudio prospectivo de 48 meses de duración, con 38 pacientes (26 hombres y 12 mujeres, con edad media de 70,9 ± 7,38 años). Todos presentaban algún grado de rectorragia y/o anemia. Se realizaron entrevistas clínicas, analíti-cas y sesiones endoscópicas con argón, de forma periódica mensual, hasta la normalización analítica y cese del sangrado, con un seguimiento posterior de 24 meses. Para valorar la mejoría se utilizaron parámetros analíticos, gradación de sangrado (Chutckan) y un índice endoscópico.Resultados: el tiempo medio trascurrido entre el inicio y la finalización del seguimiento fue de 28,5 ± 3,9 meses. La media de sesiones administradas por paciente ha sido de 3,6 ± 2,7. Si comparamos los síntomas antes, después del tratamiento existe una disminución significativa en el grado de rectorragia según la clasificación de Chutkan (2,29 ± 1,08 vs. 0,59 ± 1,12, p < 0,05). Cuando comparamos los valores medios de la hemoglobina, antes y después del tratamiento apreciamos una aumento estadísticamente significativo (11,33 ± 3,05 mg/dl vs. 14,014 ± 1,29 mg/dl, p < 0,001) así como los valores medios de ferritina (31,15 ± 66, 45 µg/dl vs. 80,60 ± 55,60 µg/dl, p < 0,05). En el índice endoscópico, también existe una mejoría evidente de la afectación endoscópica tras el tratamiento con respecto a la friabilidad (p < 0,0001) y porcentaje de mucosa afecta (p < 0,0001).Conclusión: el argón plasma es eficaz y la realización del índi-ce endoscópico es una herramienta útil para valorar la mejoría endoscópica de las lesiones tras el tratamiento.Palabras clave: APC. Argón plasma coagulación. Rectitis actíni-ca crónica. Rectorragia. Anemia. ABSTRACTObjectives: to evaluate endoscopic improvement after argon plasma coagulation (APC) in symptomatic patients with chronic radiation proctopathy.Methods and patients: a prospective study of 38 patients with radiation proctitis (26 males and 12 females, mean age 70.9 ± 7.38 yrs), and with rectal bleeding and or anemia. We performed monthly interviews, blood tests, and APC sessions until rectal bleeding had ceased and hemoglobin and ferritin levels were improved, with a follow-up of 24 months. We used blood testing, bleeding scores (Chutckhan's index), and endoscopic scores to evaluate improvement.Results: mean time between inclusion and follow-up completion was 28.5 ± 3.9 months. Mean number of sessions per patient was 3.6 ± 2.7. There was a significant decrease (2.29 ± 1.8 vs. 0.59 ± 1.12, p < 0.05) in rectal bleeding (Chutckan score) from baseline after AP...

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Argon beam coagulation for treatment of symptomatic radiation-induced proctitis

Cited by 96 publications

References 18 publications

Efficacy and safety of argon plasma coagulation for the treatment of hemorrhagic radiation proctitis

Efficacy and safety of argon plasma coagulation for the treatment of hemorrhagic radiation proctitis

Late rectal complications after prostate brachytherapy for localized prostate cancer

Valoración de la respuesta endoscópica al tratamiento con argón plasma en la rectitis actínica crónica

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