Nd:YAG laser therapy for rectal and vaginal venous malformations

Gurien, Lori A.; Jackson, Richard J.; Kiser, Michelle; Richter, Gresham T.

doi:10.1007/s00383-017-4113-4

Cited by 4 publications

(2 citation statements)

References 26 publications

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“…Nonoperative treatments for CRVM, such as sclerotherapy, snare polypectomy, neodymium-doped yttrium aluminum garnet laser therapy, and argon plasma coagulation, have been reported to decrease the amount and frequency of hematochezia. [23][24][25] However, rectal bleeding eventually recurred in most patients. In our center, one patient with limited lesions was treated with sclerotherapy and had recurrent hematochezia.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Management of Colorectal Vascular Malformation in Children: A Retrospective Study of 23 Cases

et al. 2022

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Introduction The objective of this study is to summarize the clinical characteristics and management of rare diseases of colorectal vascular malformation (CRVM) in children. Methods We retrospectively analyzed the clinical data of CRVM patients admitted to the Children's Hospital of Fudan University from 2004 to 2019. Results A total of 23 cases (16 males, 7 females) were enrolled. The median age of symptom onset was 1.4 years. Hematochezia and anemia were cardinal symptoms. Fourteen patients (60.9%) were misdiagnosed as anal fissures (n = 4), internal hemorrhoids (n = 3), rectal polyps (n = 2), inflammatory bowel disease (n = 2), portal hypertension (n = 2), and Meckel's diverticulum (n = 1), respectively. The average time from symptom onset to diagnosis was 4.5 ± 4.4 years. Other vascular malformations were detected in eight patients (34.8%). All patients showed a positive anomalous vascular image on contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI). The sensitivity of colonoscopy in the diagnosis of CRVM was 82.6% (19/23). A total of 21 patients underwent a modified Soave procedure. The lesions were mostly restricted to the colorectum and showed transmural diffuse distribution, with an average length of 20 ± 5.4 cm. Two patients (9.5%) experienced surgical complications. Bloody stools reappeared in two patients (9.5%), and colonoscopy showed abnormal angiogenesis at the anastomotic site, which were cured by sclerotherapy and/or electrocautery. The median follow-up time was 78 months. Bloody stools were absent at the last time of follow-up, and hemoglobin was in the normal range for all patients. Conclusion The identification of CRVM in children often is delayed. Colonoscopy, CT, and MRI are essential in making the correct diagnosis. The modified Soave procedure is safe and feasible to treat CRVM in children. Endoscopic sclerotherapy and/or electrocautery can be used for residual lesions.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Management of Colorectal Vascular Malformation in Children: A Retrospective Study of 23 Cases

et al. 2022

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“…Nonoperative therapies to treat CRVM, such as sclerotherapy, snare polypectomy, neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy, and argon plasma coagulation (APC), have been reported to decrease the amount and frequency of hematochezia (23)(24)(25). However, rectal bleeding eventually recurred in most patients.…”

Section: Discussionmentioning

confidence: 99%

An Investigation of Clinical Features and Exploration of Comprehensive Treatments for Colorectal Vascular Malformation in Children

Huang

Xiao

et al. 2021

Preprint

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Objectives: To summarize the clinical features, treatment methods, and outcomes of the rare diseases of colorectal vascular malformation (CRVM).Methods: We retrospectively analyzed clinical data of CRVM patients admitted to the Department of Pediatric Surgery of Children's Hospital of Fudan University from 2004 to 2019.Results: A total of 23 cases (16 males, 7 females) were enrolled. The median age of symptom onset was 1.4 years. Eleven patients had been misdiagnosed, and the average time from symptom onset to diagnosis was 4.5±4.4 years. Associated vascular malformations in the skin and other parts were found in eight patients. All patients showed a positive anomalous vascular image in the rectum and surrounding areas with contrast-enhanced computed tomography (CT) / magnetic resonance imaging (MRI). The sensitivity of endoscopy in the diagnosis of CRVM was 82.6%. A total of 21 patients underwent a modified Soave procedure. The lesions were mostly restricted to the rectum and sigmoid, with an average length of 20±5.4cm. The median follow-up time was 78 months. Bloody stools reappeared within 6 months in three patients, but were cured by sclerotherapy or fulguration. At the last time of follow-up, bloody stool symptoms were absent and hemoglobin was in the normal range for all patients.Conclusions: CRVM occurs more commonly in male children than in female children. Combined with enhanced MRI, CT, and colonoscopy, CRVM diagnosis can be confirmed. The lesioned intestinal segment can be safely removed through a modified transabdominal Soave procedure, effectively curing or relieving hematochezia.

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Lasers in Vascular Anomalies

Phillips

Richter

2021

Vascular Malformations

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Nd:YAG laser therapy for rectal and vaginal venous malformations

Abstract: Nd:YAG laser treatment of rectal and vaginal VM results in substantial improvement and symptom control, with low complication risk. Given the high morbidity of surgical resection, Nd:YAG laser treatment of pelvic VM should be considered as first line therapy.

Cited by 4 publications

References 26 publications

Clinical Characteristics and Management of Colorectal Vascular Malformation in Children: A Retrospective Study of 23 Cases

Clinical Characteristics and Management of Colorectal Vascular Malformation in Children: A Retrospective Study of 23 Cases

An Investigation of Clinical Features and Exploration of Comprehensive Treatments for Colorectal Vascular Malformation in Children

Lasers in Vascular Anomalies

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