title: Endoscopic laser coagulation of radiation-induced mucosal vascular lesions in the upper gastrointestinal tract and proximal colon.
abstract: Endoscopic laser coagulation effectively controls bleeding from radiation-induced rectal vascular lesions.
  
  
  OBJECTIVE
  To assess the outcome of endoscopic treatment of radiation-induced bleeding due to vascular lesions located proximal to the sigmoid colon.
  
  
  METHODS
  We identified 15 consecutive patients with such proximal radiation enteropathy treated at our Institution with Nd:YAG laser between 1984 and 1991. Ten patients (66%) had gastric and/or small bowel involvement, and five (33%) had colonic involvement with or without more proximal lesions. Bleeding first appeared at a mean of 21.2 +/- 12.5 months after completion of radiotherapy. Mean duration of gastrointestinal bleeding before laser treatment was 7.6 +/- 4.6 months.
  
  
  RESULTS
  After completion of laser therapy, bleeding ceased in nine (60%) patients, decreased in three (20%), and persisted in three (20%). The mean hemoglobin level increased from 8.4 +/- 0.5 g/dl to 10.4 +/- 0.6 g/dl after completion of laser treatments (p < 0.02). The mean number of transfusions per patient per year decreased from 10.5 +/- 2.8 to 0.9 +/- 0.7 (p < 0.01). No treatment-related complications or deaths occurred.
  
  
  CONCLUSIONS
  Endoscopic laser coagulation of radiation-induced mucosal vascular lesions in the upper gastrointestinal tract and proximal colon appears to be safe and, in most cases, effective.
authors.affiliation: Division of Gastroenterology, Mayo Clinic Foundation, Rochester, Minnesota.
authors.forename: J
authors.initials: J
authors.lastname: Zighelboim
authors.forename: T R
authors.initials: TR
authors.lastname: Viggiano
authors.forename: D A
authors.initials: DA
authors.lastname: Ahlquist
authors.forename: C J
authors.initials: CJ
authors.lastname: Gostout
authors.forename: K K
authors.initials: KK
authors.lastname: Wang
authors.forename: M V
authors.initials: MV
authors.lastname: Larson
mesh_terms: D003108:Colonic Diseases / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D004067:Digestive System Neoplasms / Q000532:radiotherapy; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D016558:Hemostasis, Endoscopic; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000453:epidemiology / Q000601:surgery*; D013997:Time Factors