Efficacy and safety of Nd:YAG laser for the treatment of bleeding from radiation proctocolitis.
BACKGROUND
Bleeding due to radiation proctocolitis is a frequent and severe complication of radiotherapy in cancers of the pelvis.


OBJECTIVE
The aim of this study was to evaluate the efficacy and safety of endoscopic treatment with Nd:YAG laser in this condition.


METHODS
A series of 9 patients with radiation-induced damage in the rectum and sigma were treated with endoscopic Nd:YAG laser until significant bleeding stopped and endoscopic features of proctocolitis improved. They received a median of 3 laser treatments (range 1-10) over a maximum time period of 11 months.


RESULTS
In 4 cases, bleeding ceased and, in 4, it was reduced to occasional spotting. In the remaining patient, laser therapy led to only a transient improvement, but did not modify the requirement of blood transfusion. In the 5 patients also suffering from urgency, incontinence and/or rectal mucoid discharge, the laser therapy course also relieved these symptoms. No significant treatment-related complications were observed.


CONCLUSIONS
Endoscopic Nd: YAG laser is a useful and safe treatment for patients with bleeding due to radiation proctocolitis.
Ventrucci
M
M
Dipartimento di Medicina Interna e Gastroenterologia, Laser Centre Saint Orsola Hospital and University of Bologna, Italy. ventrucc@med.unibo.it
Di Simone
M P
MP
Giulietti
P
P
De Luca
G
G
D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009354:Neodymium; D010386:Pelvic Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D011350:Proctocolitis / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D011832:Radiation Injuries / Q000175:diagnosis / Q000601:surgery*; D018570:Risk Assessment; D016896:Treatment Outcome
D009354:Neodymium