Frequency and outcomes of rectal ulcers during argon plasma coagulation for chronic radiation-induced proctopathy.
BACKGROUND
Argon plasma coagulation is suitable for treating hemorrhagic GI tract lesions. This study evaluated the frequency and clinical outcomes of complications arising during use of argon plasma coagulation to treat chronic radiation-induced proctopathy.


METHODS
This uncontrolled prospective study included 27 consecutive patients. Fever and any rectal symptoms or signs were assessed by telephone with a structured questionnaire. Patients with symptoms underwent endoscopy; follow-up examination was performed when rectal complications developed.


RESULTS
Fifty-nine therapeutic sessions were performed (mean 2 per patient; mean interval between sessions, 72.5 days); mean follow-up was 11.5 months. The treatment reduced the mean bleeding severity score from 2.8 to 0.5 (p < 0.001). Two patients (7%) experienced fever and anal pain, and 14 (52%) developed rectal ulcers but remained asymptomatic; ulcer detection never precluded further treatment. Ulcer healing was assessed in 7 patients after a mean of 141 days; no strictures were observed.


CONCLUSIONS
The frequency of complications during argon plasma coagulation for radiation-induced proctopathy was high in the present series (59%), the most frequent untoward event being the development of rectal ulcers in asymptomatic patients. However, given the benign outcome, these lesions do not necessitate discontinuation of treatment or additional monitoring.
Ravizza
Davide
D
Division of Endoscopy, European Institute of Oncology, Milan, Italy.
Fiori
Giancarla
G
Trovato
Cristina
C
Crosta
Cristiano
C
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004564:Electrocoagulation / Q000009:adverse effects*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011832:Radiation Injuries / Q000601:surgery*; D012002:Rectal Diseases / Q000601:surgery*; D012007:Rectum / Q000473:pathology*; D014456:Ulcer / Q000209:etiology*