Title: Argon Plasma Coagulation with Lower Energies for Hemorrhagic Radiation Proctitis: Report of a Case
Abstract:Radiation proctopathy (RP) is a troublesome complication of radiotherapy for pelvic malignancies and its incidence is around 5%-7.5%. We present a 79-year-old man who began passing fresh blood from hi...Radiation proctopathy (RP) is a troublesome complication of radiotherapy for pelvic malignancies and its incidence is around 5%-7.5%. We present a 79-year-old man who began passing fresh blood from his rectum after prostate cancer radiotherapy before admission to the hospital. Colonoscopy revealed friable rectal mucosa oozing blood. Under the diagnosis of hemorrhagic radiation proctitis, the patient was underwent two sessions of argon plasma coagulation (APC) at a power setting of 30 W and 1.5 L/min flow rate; bleeding stopped after treatment. For 13 months after the first APC treatment, the patient was in good condition and without recurrent rectal bleeding. Review of the literature for the treatment of PR bleeding showed that endoscopic treatment modalities are superior to medical therapy alone or surgical intervention. In 1991, Grund and Farin et al. first performed APC with a flexible endoscope. Compared to other endoscopic treatments, APC has the advantages of effectiveness, ease of use, cost effectiveness, safety, and fewer complications over other treatment modalities. The power setting for APC ranges from 25 to 60 W and the argon flow rate is 0.6 to 2 L/min; these settings effectively control the PR bleeding. The reports show that use of less power (a median of 30 W) instead of higher power produces the best results. We discuss the various power settings for APC based on clinical application.Read More
Publication Year: 2009
Publication Date: 2009-09-01
Language: en
Type: article
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