Radiofrequency ablation for the treatment of radiation proctitis

Dray, Xavier; Battaglia, G.; Wengrower, Dov; González, Pedro; Carlino, A.; Camus, Marine; Adar, Tomer; Pérez-Roldán, Francisco; Marteau, Philippe; Repici, Alessandro

doi:10.1055/s-0034-1377756

Cited by 33 publications

(32 citation statements)

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“…Furthermore, invasive endoscopic treatment should be avoided for ulcerative CRP because these treatments may pose the risk of perforation and fistula (28–31). Additionally, intrarectal formalin application also exhibited effective control of rectal bleeding in patients with CRP (26,27). However, the side effects of formalin application include anal stenosis, fissures, fecal incontinence and ulceration of the mucosa; therefore, it was not a good choice for ulcerative CRP (32,33).…”

Section: Discussionmentioning

confidence: 95%

Mesalazine suppository for the treatment of refractory ulcerative chronic radiation proctitis

Guan

Yao

et al. 2018

Exp Ther Med

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The aim of the present study was to investigate the safety and efficacy of mesalazine suppository in the treatment of refractory ulcerative chronic radiation proctitis (CRP). In total, 10 refractory ulcerative CRP patients who did not respond to previous medical treatments were recruited for the present study and were treated with mesalazine suppository (0.5 g) twice daily for 24 weeks. For each patient, the severity of clinical symptoms and endoscopic appearance was assessed before and after the treatment. For symptom scoring, the reductions in the mean total symptom score (pre- vs. post-treatment, 8.20 vs. 0.90; P<0.01), rectal bleeding score (2.40 vs. 0.30; P<0.01), rectal pain score (2.00 vs. 0.50; P<0.01), stool frequency score (2.00 vs. 0.10; P<0.01) and tenesmus score (1.80 vs. 0.00; P<0.01) were all statistically significant. For mucosal damage scoring, there was a reduction in the mean scores for total scores (9.22 vs. 5.22; P<0.01), telangiectasia (2.78 vs. 1.89; P=0.009), edema (2.89 vs. 1.78; P=0.001) and ulceration (2.44 vs. 0.89; P=0.003). However, statistically reductions in the median symptom scores were not observed for stenosis (0.78 vs. 0.67; P=0.347) and necrosis (0.33 vs. 0.00; P=0.081). Furthermore, no adverse events were observed during and after the treatment. The topical mesalazine suppository may be a safe and effective treatment for CRP, particularly for patients with deep ulcers. Adequately randomized controlled trials are required to confirm the results of the present study.

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Section: Discussionmentioning

confidence: 95%

Mesalazine suppository for the treatment of refractory ulcerative chronic radiation proctitis

Guan

Yao

et al. 2018

Exp Ther Med

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“…After a median of two RFA sessions and at 6 months of follow-up, significant improvement was seen in symptoms (bleeding and tenesmus) and mean hemoglobin concentration, and 69% of patients who previously required transfusions no longer needed them. [39]…”

Section: Evolving Techniques In Endoscopic Hemostasismentioning

confidence: 99%

Evolving techniques for gastrointestinal endoscopic hemostasis treatment

Ghassemi

Jensen

2016

Expert Review of Gastroenterology & Hepatology

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With mortality due to gastrointestinal (GI) bleeding remaining stable, the focus on endoscopic hemostasis has been on improving other outcomes such as rebleeding rate, need for transfusions, and need for angiographic embolization or surgery. Over the past few years, a number of devices have emerged to help endoscopically assess and treat bleeding GI lesions. These include the Doppler endoscopic probe, hemostatic powder, and over-the-scope clip. Also, new applications have been described for radiofrequency ablation. In this article, we will discuss these evolving tools and techniques that have been developed, including an analysis of their efficacy and limitations.

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“…Chronic RP is a complication of RT for pelvic malignancies, reported in up to 20% of the patients [1, 2]. APC is considered the preferred therapy, with an overall success rate as high as 80% [1, 3].…”

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confidence: 99%

“…APC is considered the preferred therapy, with an overall success rate as high as 80% [1, 3]. However, it has been associated with serious complications (e.g., perforation, fistulas, and strictures), and the efficacy is limited in patients with active bleeding, extensive disease and distally located lesions (anorectal junction) [2, 4]. RFA covers a broader area, has a superficial depth of ablation (0.5–1 mm), reducing the potential risk for fibrosis and stricture formation [2, 3], and has emerged as a promising alternative treatment [1].…”

mentioning

confidence: 99%

“…However, it has been associated with serious complications (e.g., perforation, fistulas, and strictures), and the efficacy is limited in patients with active bleeding, extensive disease and distally located lesions (anorectal junction) [2, 4]. RFA covers a broader area, has a superficial depth of ablation (0.5–1 mm), reducing the potential risk for fibrosis and stricture formation [2, 3], and has emerged as a promising alternative treatment [1]. According to Rustagi et al [1], who published the largest series of patients managed by RFA ( n = 39), this technique showed 96% improvement of the endoscopic severity score, 100% efficacy in stopping bleeding, and 92% of blood transfusion discontinuation, with no major complications [1].…”

mentioning

confidence: 99%

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