Argon plasma coagulation therapy for hemorrhagic radiation proctosigmoiditis

Silva, Rui André Martins; Correia, António Jorge; Dias, Luis Moreira; Viana, Helena Lomba; Viana, Rafael Lomba

doi:10.1016/s0016-5107(99)70228-2

Cited by 138 publications

(83 citation statements)

References 20 publications

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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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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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“…Argon plasma coagulation therapy appears to be a simple, safe, and effective technique in the management of hemorrhagic radiation-induced proctosigmoiditis and is now generally accepted as the treatment of choice followed by local application of formalin if this fails [31,72,73] . Argon plasma coagulation, a non-contact ther mal coagulation technique that reduces rectal bleeding in 80%-90% of cases, is applied endoscopically, with a probe passing through the endoscope that delivers a field of argon gas to the mucosal surface, where it is ionized by a high-voltage filament resulting in superficial mucosal heating and coagulation of friable blood vessels.…”

Section: Control Of Bleedingmentioning

confidence: 99%

Recent advances in the management of radiation colitis

Kountouras¹,

Zavos²

2008

WJG

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“…Other studies None of the references in this section state the grade of the proctitis and one study (Silva et al, 1999) uses a formal score to quantify rectal bleeding pre-and post-treatment allowing an objective comparison to be conducted. Generally, outcome assessments used are presence or absence of bleeding, control of bleeding, haemoglobin pre-and post-treatment and transfusion requirements.…”

Section: Clinicalmentioning

confidence: 99%

Systematic review for non-surgical interventions for the management of late radiation proctitis

et al. 2002

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Chronic radiation proctitis produces a range of clinical symptoms for which there is currently no recommended standard management. The aim of this review was to identify the various non-surgical treatment options for the management of late chronic radiation proctitis and evaluate the evidence for their efficacy. Synonyms for radiation therapy and for the spectrum of lower gastrointestinal radiation toxicity were combined in an extensive search strategy and applied to a range of databases. The included studies were those that involved interventions for the non-surgical management of late radiation proctitis. Sixtythree studies were identified that met the inclusion criteria, including six randomised controlled trials that described the effects of anti-inflammatory agents in combination, rectal steroids alone, rectal sucralfate, short chain fatty acid enemas and different types of thermal therapy. However, these studies could not be compared. If the management of late radiation proctitis is to become evidence based, then, in view of its episodic and variable nature, placebo controlled studies need to be conducted to clarify which therapeutic options should be recommended. From the current data, although certain interventions look promising and may be effective, one small or modest sized study, even if well-conducted, is insufficient to implement changes in practice. In order to increase recruitment to trials, a national register of cases with established late radiation toxicity would facilitate multi-centre trials with specific entry criteria, formal baseline and therapeutic assessments providing standardised outcome data.

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Argon plasma coagulation therapy for hemorrhagic radiation proctosigmoiditis

Cited by 138 publications

References 20 publications

Late rectal complications after prostate brachytherapy for localized prostate cancer

Late rectal complications after prostate brachytherapy for localized prostate cancer

Recent advances in the management of radiation colitis

Systematic review for non-surgical interventions for the management of late radiation proctitis

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