Evaluation of the endoscopic response to argon plasma coagulation in patients with chronic radiation proctopathy

• Published in: Revista española de enfermedades digestivas Vol. 100; no. 10; p. 619
• Main Authors: Latorre Sánchez, M, Sempere García-Argüelles, J, Barceló Cerdá, S, Huguet Malaves, J M, Canelles Gamir, P, Quiles Teodoro, F, Medina Chuliá, E
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.10.2008
• Subjects: Aged; Anemia - etiology; Argon - therapeutic use; Chronic Disease; Data Interpretation, Statistical; Female; Follow-Up Studies; Gastrointestinal Hemorrhage - surgery; Hemostasis, Endoscopic; Humans; Interviews as Topic; Laser Coagulation - methods; Male; Middle Aged; Proctitis - diagnosis; Proctitis - etiology; Proctitis - surgery; Prospective Studies; Radiation Injuries - complications; Radiation Injuries - diagnosis; Radiation Injuries - surgery; Radiotherapy - adverse effects; Time Factors; Treatment Outcome
• ISSN: 1130-0108

To evaluate endoscopic improvement after argon plasma coagulation (APC) in symptomatic patients with chronic radiation proctopathy. 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. 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 APC. There was a significant increase in hemoglobin levels (11.3 +/- 3.05 vs. 14.014 +/- 1.29, p < 0.001) and ferritin levels (31.15 +/- 66.45 vs. 80.60 +/- 55.6, p < 0.05) from baseline after APC. Also, there was improvement in the endoscopic index at the end of treatment, as well as in friability (p < 0.0001) and involved surface area (p < 0.0001). Argon plasma coagulation is an effective technique, and the endoscopic index is a useful tool to evaluate endoscopic improvement.