Endorectal formalin instillation or argon plasma coagulation for hemorrhagic radiation proctopathy therapy: a prospective and randomized clinical trial

Furtado, Flávia S.; Furtado, Gildo B.; Oliveira, Alessandrino Terceiro de; Oliveira, Francisco A.A.; Pinho, Cibele Silveira; Sampaio, João P.A.; Feitosa, Ana M.L.; Junir, José Ruver de Lima Herculano

doi:10.1016/j.gie.2020.11.007

Cited by 10 publications

(24 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In regard to endoscopic treatments, APC is usually the first-choice treatment modality for CRP, although no consensus exists regarding the best APC settings. Reported success rates for APC are between 70 % and 90 %, with at least two sessions in most of treated patients 6 13 14 15 . However, if disease is extensive disease, more than two sessions may be required, and the presence of telangiectasias on more than 50 % of the surface area has been demonstrated to be related to APC failure 14 .…”

Section: Discussionmentioning

confidence: 99%

“…In regard to endoscopic treatments, APC is usually the firstchoice treatment modality for CRP, although no consensus exists regarding the best APC settings. Reported success rates for APC are between 70 % and 90 %, with at least two sessions in most of treated patients [6,[13][14][15]. However, if disease is extensive disease, more than two sessions may be required, and ▶ Fig.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Rectal band ligation as a treatment for chronic radiation proctitis: a feasibility study

et al. 2022

View full text Add to dashboard Cite

Background and study aims: Chronic radiation proctitis (CRP) occurs in 5-20% of patients undergoing pelvic radiation therapy and frequently manifests with rectal bleeding. Endoscopic management of more severe and refractory cases can be challenging. Rectal band ligation (RBL) has been shown to be a feasible alternative to current available techniques, especially in extensive CRP. Our aim is to evaluate clinical and technical success of RBL. Patients and methods: We enrolled all consecutive patients treated with RBL for severe or recurrent hemorrhagic CRP. Success was defined as endoscopic evidence of complete rectal healing and/or cessation of bleeding not requiring further treatment or blood transfusion. Results: We enrolled 10 patients (7 males, mean age 75.6 years). Median length of the CRP from the anal verge was 4.5 cm and mean surface area involved was 89%. Eight patients (80%) were naïve of endoscopic treatment, while 2 underwent APC. Median follow-up was of 136.5 days. Success was achieved in 100% of patients after a mean number of 1.8 RBL sessions. A mean number of 4.7 bands were released in the first session while a mean of 3.1 and 2 bands were respectively placed in the second and third session. As for adverse events, only 1 patient reported mild tenesmus and pelvic pain after the procedure. Conclusions: RBL is a safe and effective therapeutic modality for the treatment of hemorrhagic CRP. It could be considered a valid first-line option in case of extensive rectal involvement as well as a viable rescue treatment after failed APC.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rectal band ligation as a treatment for chronic radiation proctitis: a feasibility study

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The intercellular proteins are also coagulated and converted into gelatin. When the temperature rises to 100 °C, the cell fluid begins to evaporate; afterwards, the temperature rises above 100 °C, and the remaining material may burn and cause unwanted carbonization [ 6 , 17 , 33 , 35 ].…”

Section: Thermal Effect Of Plasma Scalpelmentioning

confidence: 99%

“…The thermal effect of the plasma scalpel is shown in Figure 6 . Depending on the distance from the plasma, evaporation, carbonization, dessication, coagulation, devitalization, and hyperthermia occur in sequence [ 33 , 35 ]. Plasma tissue cutting occurs when the plasma contacts the tissue and the temperature rapidly rises to 100 °C or higher, causing the cells to vaporize and explode.…”

Section: Thermal Effect Of Plasma Scalpelmentioning

confidence: 99%

Plasma Scalpels: Devices, Diagnostics, and Applications

Xiao

Liu

He³

et al. 2022

Biomedicines

View full text Add to dashboard Cite

The plasma scalpel is an application of gas discharges in electrosurgery. This paper introduces the device structure and physicochemical parameters of the two types of plasma scalpels, namely, a single-electrode Ar discharge device (argon plasma coagulation) and a two-electrode discharge device in normal saline. The diagnostic methods, including the voltage and current characteristics, optical emission spectroscopy, electron spin resonance, and high-speed imaging, are introduced to determine the critical process parameters, such as the plasma power, the gas temperature, the electron density, and the density of active species, and study the ignition dynamics of the plasma discharges in water. The efficacy of the plasma scalpel is mainly based on the physical effects of the electric current and electric field, in addition to the chemical effects of high-density energetic electrons and reactive species. These two effects can be adjusted separately to increase the treatment efficacy of the plasma scalpel. Specific guidance on further improvements of the plasma scalpel devices is also provided.

show abstract

“…Hemorrhagic radiation proctopathy is a long-lasting side effect of radiotherapy for gynecologic, urologic, and digestive cancers that is characterized by hematochezia from mucosal angioectasia, and a variable degree of rectal pain, tenesmus, urgency, and incontinence [1]. When symptoms or anemia occur despite medical treatment, endoscopic therapy with radiofrequency ablation or argon plasma coagulation represents the first option, with appreciable but still suboptimal endoscopic and clinical long-term results [1,2]. Here we report the case of a 51-year-old woman with severe chronic hematochezia, moderate-to-severe iron deficiency anemia, tenesmus, and urgency.…”

mentioning

confidence: 99%

Water-immersion and cap-assisted endoscopic ablation of hemorrhagic radiation proctopathy with a novel 1.9/1.5-μm dual-emission endoscopic laser treatment

et al. 2023

View full text Add to dashboard Cite

Endorectal formalin instillation or argon plasma coagulation for hemorrhagic radiation proctopathy therapy: a prospective and randomized clinical trial

Cited by 10 publications

References 26 publications

Rectal band ligation as a treatment for chronic radiation proctitis: a feasibility study

Rectal band ligation as a treatment for chronic radiation proctitis: a feasibility study

Plasma Scalpels: Devices, Diagnostics, and Applications

Water-immersion and cap-assisted endoscopic ablation of hemorrhagic radiation proctopathy with a novel 1.9/1.5-μm dual-emission endoscopic laser treatment

Contact Info

Product

Resources

About