title: [Therapeutic strategy for hemorrhagic radiation proctitis--the optimum condition of argon plasma coagulation (APC)].
abstract: OBJECTIVE
  This study was performed to clarify the optimum condition of argon plasma coagulation (APC) to treat hemorrhagic radiation proctitis.
  
  
  METHODS
  Among 25 patients with hemorrhagic radiation proctitis treated in the Cancer Institute Hospital between December 2000 and May 2004, 18 were followed-up for more than 6 months. The clinical courses of these 18 patients were analyzed retrospectively.
  
  
  METHODS
  Proctoscopic findings of the hemorrhagic lesions were categorized as type-A (localized dilated veins, n = 6) , type-B (diffuse dilated veins, n = 6), and type-C (dilated veins associated with ulcers orerosions, n = 6). APC was applied for 5-10 seconds with the power of 40 W and the argon flow of 1.0 l/min (high power APC), or for 1-2 seconds with the power of 40 W and the argon flow of 0.6 l/min (low power APC).
  
  
  RESULTS
  Type-A and B patients were successfully treated with either low or high power APC without any serious complications. But some type-C patients treated with high power APC showed serious complications such as proctovaginal fistula or prolonged ulceration. No recurrence patients were 89% (16/18) during the mean follow up period of 18 +/- 9.9 months.
  
  
  CONCLUSIONS
  APC therapy for hemorrhagic radiation-proctitis was useful, but the pathologic healing process and consequence were different by rectal mucosal weakness. It is necessary for the therapeutic strategy to be put up and down according to proctoscopic findings. As for the optimum condision APC short cauterization by low power setting was more recommended.
authors.affiliation: Division of Gastroenterology, Cancer Institute Hospital.
authors.forename: Akiko
authors.initials: A
authors.lastname: Chino
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Uragami
authors.forename: Hisashi
authors.initials: H
authors.lastname: Hosaka
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Ishiyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Tatewaki
authors.forename: Yorimasa
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Tsuchida
authors.forename: Junko
authors.initials: J
authors.lastname: Fujisaki
authors.forename: Etsuo
authors.initials: E
authors.lastname: Hoshino
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.forename: Rikiya
authors.initials: R
authors.lastname: Fujita
authors.forename: Kouichi
authors.initials: K
authors.lastname: Koizumi
mesh_terms: D000368:Aged; D001128:Argon / Q000627:therapeutic use; D004564:Electrocoagulation; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011349:Proctitis / Q000209:etiology / Q000601:surgery*; D011832:Radiation Injuries / Q000601:surgery*; D012189:Retrospective Studies
chemical_list: D001128:Argon