title: [Long term results of treatment of hemorrhagic radiation proctitis by argon plasma coagulation].
abstract: OBJECTIVE
  To assess long term results of argon plasma coagulation (APC) treatment in hemorrhagic radiation proctitis.
  
  
  METHODS
  Thirty patients treated with APC in 2 departments were enrolled. In 16 patients, APC was the first treatment used. A clinical scale (Chutkan) was used to assess bleeding before and after treatment. An endoscopic scale was used to assess results on mucosa appearance.
  
  
  RESULTS
  The mean course number was 2.3 (extremes 1-5). Bleeding score decreased from 2.67 to 0.77 (P<0.001). The success rate was 26/30 patients (87%) in an intention-to-treat analysis with 2 failures (6%), 1 patient lost for follow up and 1 patient not referred after one session. Improvement in endoscopic appearance was observed in the 13 endoscopically controlled patients with a decrease of the endoscopic score from 1.61 to 0.3 (P<0.002). The overall morbidity was 47% with 3 severe complications (10%): 1 severe bleeding, 1 extensive necrosis of lower part of the rectum and 1 perforation. We also noticed 3 microrecties and 2 symptomless rectal stenosis. With regard to tolerance, we observed post treatment pain in 6 patients (20%), easily released by usual antalgics. Complications and side effects occurred, in all patients but one, when power shot was > 45 W. Mean follow up was 20 months (3 to 35 months). Hematochezia recurred in 4 patients, but were easily treated with 1 APC course.
  
  
  CONCLUSIONS
  APC is an effective treatment of hemorrhagic radiation proctitis, with a success rate of 87%. Endoscopic improvement is usual. It seems to be possible to limit the risk of complications by using low power setting.
authors.affiliation: Centre Médico-Chirurgical du Trocadéro.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Canard
authors.forename: Bruno
authors.initials: B
authors.lastname: Védrenne
authors.forename: Georges
authors.initials: G
authors.lastname: Bors
authors.forename: Pierre
authors.initials: P
authors.lastname: Claude
authors.forename: Robert
authors.initials: R
authors.lastname: Bader
authors.forename: Daniel
authors.initials: D
authors.lastname: Sondag
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001128:Argon / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016558:Hemostasis, Endoscopic / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008028:Light Coagulation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010386:Pelvic Neoplasms / Q000532:radiotherapy; D011349:Proctitis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011351:Proctoscopy / Q000009:adverse effects / Q000379:methods*; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012002:Rectal Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D001128:Argon