Efficacy and complications of argon plasma coagulation for hemorrhagic chronic radiation proctitis.

摘要: Background Chronic radiation proctitis (CRP) is a complication which occurs in 1%-5% of patients who undergo radiotherapy for pelvic malignancies. Although wide range therapeutic modalities are available, there no literature to date showing any particularly appropriate modality each disease stage. Argon plasma coagulation (APC) currently recommended as the first-choice treatment hemorrhagic CRP, however, its indication based on long-term follow-up still unclear. On hypothesis that efficacy and safety APC not fully understood, we reviewed with CRP from single center. Aim To assess CRP. Methods This retrospective study consecutive treated January 2013 October 2017. Demographics, clinical variables, typical endoscopic features were recorded independently. Success was defined either cessation bleeding or only occasional traces bloody stools further treatments at least 12 mo after last treatment. We performed univariate multivariate analyses identify factors associated success risk fistulas. Results Forty-five median period 24 (range: 12-67 mo) enrolled. Fifteen (33.3%) required blood transfusion before APC. Successful achieved 31 (68.9%) patients. The mean number sessions 1.3 (1-3). Multivariate analysis showed failure independently telangiectasias present more than 50% surface area [odds ratio (OR) = 6.53, 95% confidence interval (CI): 1.09-39.19, P 0.04] ulcerated greater 1 cm2 (OR 8.15, 95%CI: 1.63-40.88, 0.01). Six (13.3%) had severe complications involving rectal fistulation. factor significantly (P 0.035). Conclusion uncertain > ulceration cm2.