Endoscopic therapy for radiation proctitis-induced hemorrhage in patients with prostatic carcinoma using argon plasma coagulator application.
BACKGROUND
Recurrent hemorrhage in patients with severe radiation proctitis is very common. It is often refractory to medical therapy. Endoscopic and surgical treatment may be required when conservative medical therapy fails. The aim of this study was to assess the therapeutic results of the Argon Plasma Coagulator (APC) (ERBE USA, Inc., Marietta, GA, USA) application in patients with radiation proctitis-induced hemorrhage.


METHODS
Forty patients with radiation-induced proctitis causing severe bleeding, who had failed conservative medical management were treated endoscopically. Twenty-one patients in this group required blood transfusions.


RESULTS
APC application was used in 40 patients with only one failure. The failed patient underwent formalin application using 4% formalin solution with resolution of the bleeding.


CONCLUSIONS
Argon plasma coagulation application is a safe, well-tolerated treatment option and, historically, has been superior to Nd:YAG laser ablation.
Venkatesh
K S
KS
Endoscopic Department, Valley Lutheran Hospital, Mesa, AZ 85202, USA.
Ramanujam
P
P
D000284:Administration, Oral; D000285:Administration, Rectal; D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D001128:Argon / Q000627:therapeutic use*; D001803:Blood Transfusion / Q000379:methods; D004334:Drug Administration Schedule; D004564:Electrocoagulation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000209:etiology / Q000601:surgery*; D016558:Hemostasis, Endoscopic / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D011349:Proctitis / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D011467:Prostate / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects / Q000601:surgery; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011878:Radiotherapy / Q000009:adverse effects*; D013256:Steroids
D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D013256:Steroids; D019804:Mesalamine; D001128:Argon