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- W2108030897 abstract "Radiation therapy for pelvic neoplasia is widely employed for both curative and palliative intent. Although safe and effective, 5|[ndash]|10% patients experience the undesirable complication of radiation proctitis (more properly called proctopathy). The rectal bleeding is typically intermittent but rarely presents as acute lower GI bleeding. Endoscopic evaluation reveals scattered vascular ectasias throughout the rectum|[sol]|distal sigmoid. The vascular ectasias are felt to arise from neoangiogenesis resultant from vascular wall fibrosis induced by radiation. Many modalities for treatment have been employed including topical application of various agents (formaldehyde, short-chain fatty acids, sulfasalazine, 5-ASA), endoscopic use of Nd:YAG laser, bipolar cautery and various surgical interventions. APC is a new endoscopic coagulation modality employing pressurized ionized argon gas delivered via polyethylene catheter to achieve superficial cauterization. Five patients diagnosed with symptomatic radiation proctopathy and anemia underwent APC at our institution within the past 18 months. One patient had been treated previously with YAG laser. During each endoscopic treatment session a flexible sigmoidoscopy was performed followed by ablation of rectal ectasias by APC. Routine APC application consisted of multiple, brief pulses from the APC device (ERBE) set at 60|[ndash]|65 watts applied by mucosal |[ldquo]|painting|[rdquo]| over focal areas of visible ectasias. Patients received a mean of 4.6 (range 2|[ndash]|7) treatment sessions (approx. one session every 3 wks). Hematocrit (Hct) values immediately preceding APC therapy and packed red blood cell transfusions (PRBC) during a 6 month interval prior to APC were compared to Hct and PRBC requirements during APC therapy. Hct values remained stable or improved while the need for PRBC was either eliminated or substantially decreased in all patients. Statistical significance was not achieved due to the limited sample size. All patients tolerated the procedure well with no complications noted." @default.
- W2108030897 created "2016-06-24" @default.
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- W2108030897 date "2000-09-01" @default.
- W2108030897 modified "2023-09-27" @default.
- W2108030897 title "Endoscopic argon plasma coagulation (APC) for radiation proctopathy" @default.
- W2108030897 doi "https://doi.org/10.1016/s0002-9270(00)01543-4" @default.
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