Abstract

LATORRE SANCHEZ, M. et al. Evaluation of the endoscopic response to argon plasma coagulation in patients with chronic radiation proctopathy. Rev. esp. enferm. dig. [online]. 2008, vol.100, n.10, pp.619-624. ISSN 1130-0108.

Objectives: to evaluate endoscopic improvement after argon plasma coagulation (APC) in symptomatic patients with chronic radiation proctopathy. Methods and patients: 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). Conclusion: argon plasma coagulation is an effective technique, and the endoscopic index is a useful tool to evaluate endoscopic improvement.

Keywords : APC; Argon plasma coagulation; Chronic radiation proctopathy; Rectal bleeding; Anaemia.

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