[Evaluation of the endoscopic response to argon plasma coagulation in patients with chronic radiation proctopathy].
OBJECTIVE
To evaluate endoscopic improvement after argon plasma coagulation (APC) in symptomatic patients with chronic radiation proctopathy.


METHODS
A prospective study of 38 patients with radiation proctitis (26 males and 12 females, mean age 70.9 +/- 7.38 yrs), and with rectal bleeding and or anemia. We performed monthly interviews, blood tests, and APC sessions until rectal bleeding had ceased and hemoglobin and ferritin levels were improved, with a follow-up of 24 months. We used blood testing, bleeding scores (Chutckhan's index), and endoscopic scores to evaluate improvement.


RESULTS
Mean time between inclusion and follow-up completion was 28.5 +/- 3.9 months. Mean number of sessions per patient was 3.6 +/- 2.7. There was a significant decrease (2.29 +/- 1.8 vs. 0.59 +/- 1.12, p < 0.05) in rectal bleeding (Chutckan score) from baseline after APC. There was a significant increase in hemoglobin levels (11.3 +/- 3.05 vs. 14.014 +/- 1.29, p < 0.001) and ferritin levels (31.15 +/- 66.45 vs. 80.60 +/- 55.6, p < 0.05) from baseline after APC. Also, there was improvement in the endoscopic index at the end of treatment, as well as in friability (p < 0.0001) and involved surface area (p < 0.0001).


CONCLUSIONS
Argon plasma coagulation is an effective technique, and the endoscopic index is a useful tool to evaluate endoscopic improvement.
Latorre Sánchez
M
M
Servicio de Digestivo, Consorcio Hospital General Universitario de Valencia. mercedeslatorre@msn.com
Sempere García-Argüelles
J
J
Barceló Cerdá
S
S
Huguet Malaves
J M
JM
Canelles Gamir
P
P
Quiles Teodoro
F
F
Medina Chuliá
E
E
D000368:Aged; D000740:Anemia / Q000209:etiology; D001128:Argon / Q000627:therapeutic use; D002908:Chronic Disease; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D016558:Hemostasis, Endoscopic; D006801:Humans; D007407:Interviews as Topic; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011349:Proctitis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D011832:Radiation Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D011878:Radiotherapy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
D001128:Argon