KTP laser therapy for bleeding from chronic radiation proctopathy.
BACKGROUND
Endoscopic laser photocoagulation is commonly used to treat bleeding from the neovascular lesions of chronic radiation proctopathy. The KTP laser is an Nd/YAG-driven unit that emits light with a wavelength of 532 nm. This wavelength of energy is absorbed by hemoglobin and penetrates tissue to a depth of only 1 to 2 mm.


METHODS
Twenty-three patients were treated with KTP laser and followed for a median of 29 months (range 5 to 51 months); 21 had received radiation for prostate cancer and 2 for uterine cancer. The median age was 77 years (range 68 to 87 years). A median of 2 sessions (range 1 to 5 sessions) was performed using 4 to 10 Watts of power and a median energy of 816 Joules per session (range 204 to 2430 Joules).


RESULTS
After treatment there was a significant reduction in the frequency (p = 0.0005) of bleeding, increase in hematocrit level (p < 0.0001), improvement in activities of daily life (p = 0.01), and a reduction in use of health care resources (p < 0.0001). There was a trend toward decreased use of iron supplements (11 to 4 patients) and transfusions (4 to 0 patients). Two patients (9%) developed rectal ulcers after treatment.


CONCLUSIONS
KTP laser photocoagulation is a safe and effective therapy for bleeding from chronic radiation proctopathy that improves activities of daily living and reduces use of health care resources.
Taylor
J G
JG
University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
Disario
J A
JA
Bjorkman
D J
DJ
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D011349:Proctitis / Q000209:etiology / Q000601:surgery*; D011351:Proctoscopy; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000532:radiotherapy; D011832:Radiation Injuries / Q000150:complications* / Q000601:surgery; D012189:Retrospective Studies; D055502:Secondary Prevention; D014594:Uterine Neoplasms / Q000532:radiotherapy