Document Detail


Endoscopic treatments for chronic radiation proctitis.
MedLine Citation:
PMID:  23858374     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Chronic radiation proctitis is a complication that occurs in patients who receive radiation therapy for pelvic malignancies. The common presentation is with rectal bleeding, but also rectal pain, diarrhea, tenesmus and even passage of mucus can occur. The optimal treatment of bleeding due to radiation proctitis remains unclear. Among various therapeutic options, medical management is generally ineffective and surgical intervention has a high incidence of morbidity. Promising advances have been made in endoscopic therapy, including argon plasma coagulation (APC), formalin application as well as new techniques such as radiofrequency ablation and cryoablation. APC is a safe, highly effective and long-lasting therapy in patients with rectal bleeding associated with radiation proctitis. It has been shown that several sessions of APC reduce the rate of bleeding and therefore the blood transfusion requirements. Moreover, the effect of treatment is long lasting. However, best results are achieved in patients with mild to moderate radiation proctitis, leaving space for alternative treatments for patients with more severe disease. In patients with severe or refractory radiation proctitis intra rectal formalin application is an appropriate treatment option. Radiofrequency ablation and cryoablation have shown efficacy as alternative methods in a limited number of patients with refractory chronic radiation proctitis.
Authors:
George Karamanolis; Panagiota Psatha; Konstantinos Triantafyllou
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of gastrointestinal endoscopy     Volume:  5     ISSN:  1948-5190     ISO Abbreviation:  World J Gastrointest Endosc     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-07-16     Completed Date:  2013-07-16     Revised Date:  2013-07-18    
Medline Journal Info:
Nlm Unique ID:  101532474     Medline TA:  World J Gastrointest Endosc     Country:  China    
Other Details:
Languages:  eng     Pagination:  308-12     Citation Subset:  -    
Affiliation:
George Karamanolis, Gastroenterology Unit, 2 Department of Surgery, "Aretaieio" University Hospital, Athens University, 11528 Athens, Greece.
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