title: Comparative study of bipolar eletrocoagulation versus argon plasma coagulation for rectal bleeding due to chronic radiation coloproctopathy.
abstract: OBJECTIVE
  Chronic radiation coloproctopathy (CRCP) is a well-recognized complication of radiotherapy, with rectal bleeding the most common presentation. It is frequently refractory to conservative management, but the optimal endoscopic treatment of bleeding secondary to CRCP is still controversial. The efficacy and safety of bipolar eletrocoagulation (BEC) and argon plasma coagulation (APC) in the management of bleeding from CRCP were evaluated and compared.
  
  
  METHODS
  30 patients (mean age 67.4 years) with active and chronic bleeding from telangiectasias, were randomly allocated to BEC or APC and stratified by severity of CRCP according to clinical severity and endoscopic findings (Saunders score). Success was defined as eradication of all telangiectasias, and therapeutic failure as need for more than seven sessions or for other treatment. Complications were categorized as minor (e.g. fever, anal or abdominal pain) or major (hemorrhagic).
  
  
  RESULTS
  Both treatments were equally effective for the treatment of CRCP rectal bleeding. Only one failure was observed in each group (P = 1.000). There was no significant difference between the two groups regarding number of sessions, minor or major complications, or relapse. However, overall complication rate was significantly higher in the BEC group (P = 0.003).
  
  
  CONCLUSIONS
  BEC and APC are both effective for the therapy of bleeding telangiectasias from CRCP. There are probably no major differences between them. Although APC seemed safer than BEC in this investigation, further studies, involving a much larger population, are needed to assess the complication rates and determine the best management option.
authors: Endoscopy Unit, Universidade Federal de São Paulo, Brazil. Luciano.lenz@terra.com.br
authors: L
authors: L
authors: Lenz
authors: J
authors: J
authors: Tafarel
authors: L
authors: L
authors: Correia
authors: D
authors: D
authors: Bonilha
authors: M
authors: M
authors: Santos
authors: R
authors: R
authors: Rodrigues
authors: G
authors: G
authors: Gomes
authors: G
authors: G
authors: Andrade
authors: F
authors: F
authors: Martins
authors: M
authors: M
authors: Monaghan
authors: F
authors: F
authors: Nakao
authors: E
authors: E
authors: Libera
authors: A P
authors: AP
authors: Ferrari
authors: R
authors: R
authors: Rohr