[Bipolar electrocoagulation in patients with persistent hemorrhage secondary to second degree postradiation proctopathy].
OBJECTIVE
Our objective was to evaluate response to bipolar electrocoagulation (BICAP) in patients with persistent rectorragia (PR) secondary to PRP (post-radiation proctitis) degree II (telangiectasias).


METHODS
We had 64 cases prospective and conducted study cohort of 257 patients, with cervicouterine cancer, radiated, PRP degree II, and PR.


METHODS
We conducted prospective, cross-sectional and descriptive study. Patients were divided in three groups: (group 1), with hemodynamical instability; (group 2) with chronic anemia, and (group 3), without data of chronic anemia (Table 1). Clinical evaluation was carried out before and after the intervention (BICAP). BICAP of radial way at level of telangiectasias was applied, of sigmoides up to 2 cm of anal margin. Three sessions were average.


RESULTS
A total of 55 patients had PR radiation dose average, with 49.85 Gy. Time average of appearance of rectorragia was 9 months. GROUP 1: A total of 21 patients, age 51.2 years average). Previous to BICAP, week by frequency of rectorragia was 2.23 (average). With hemoglobin (Hb) and hematocrit (Ht) of 7.1 g (average) and 24.4%, respectively (average). A total of 18 patients (85.7%) required hemotransfusion. Average hospital stay was 1.3 days. Cardiac frequency, arterial, blood and hemoglobin pressure, and hematocrit obtained later improvement to intervention with BICAP was statistically significant (p > 0.0001). Patients did not require additional blood transfusions. GROUP 2: A total of 18 patients with age average 56 years (average). Previous to BICAP they had weekly rectorragia of 2.16 (average). Hb was 11.4 g and Ht of 35.5% (average). Subsequent to BICAP, 100% patients had controlled hemostasis. The improvement observed with regard to cardiac frequency and blood pressure after application of BICAP did not have statistical significance despite the fact that it was demonstrated to laboratory parameters as well as diminution of weekly episodes of rectorragia if they were statistically significant (p > 0.0001). No blood transfusion was required. GROUP 3: There were 16 patients with average of 57.1 years of age (average). Previous to BICAP they had weekly 1 rectorragia of 2.06, Hb of 13.5 g and Ht of 41.2% (average). Subsequent to BICAP, there was 100% controlled haemostasis. In this group, diminution of weekly episodes of rectorragia, cardiac frequency, and blood pressure did not have statistically significant changes; nevertheless, hemoglobin and hematocrit had a statistically significant increase (p > 0.0001). No blood transfusion was required.


CONCLUSIONS
Electrocoagulation (BICAP) is effective in hemostasis of bleeding telangiectasias, stabilizing to the patient, and diminishing recurrence, hospital stay, and blood requirements.
Castro Ruíz
José Manuel
JM
Servicio de Endoscopia, Instituto de Cancerología, Avenida San Fernando No. 22, Col. Sección XV, Tlalpan 14000, México, D.F. cas_truz@hotmail.com
Hernández Guerrero
Angélica
A
Sobrino Cossio
Sergio
S
Alonso
Octavio
O
Rivero Trejo
Leopoldo
L
D003430:Cross-Sectional Studies; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D011349:Proctitis / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D011832:Radiation Injuries / Q000150:complications / Q000601:surgery*; D012007:Rectum / Q000473:pathology / Q000601:surgery