Background And Aims: Radiotherapy may cause hemorrhagic radiation proctopathy (HRP). For conservative treatment of refractory HRP, argon plasma coagulation (APC) is the first-choice therapy. Endorectal formalin instillation (EFI), in turn, is an attractive treatment option because of its satisfactory results, great availability, and low cost. Nevertheless, comparative studies between these procedures are rather scarce. This study aims to make a prospective and randomized comparison of the outcomes in 2 HRP patient groups treated with either APC or EFI.
Methods: Twenty-seven patients (11 women), with a mean age of 67 years (range, 36-83), were randomized to receive either APC (n = 14) or EFI (n = 13). On completion of the treatment, comparisons were made in relation to the baseline for each patient and between groups for endoscopic findings according to the Vienna score and the telangiectasia distribution pattern score (TDP); the impact of radiation proctitis on patients' lives was made according to the modified radiation toxicity score (MRTS) and hemoglobin levels. Number of sessions, duration of therapy, and adverse events were also compared between groups. The endoscopic therapeutic success (ETS) was defined by the absence or only few residual telangiectasias (TDP ≤1) on conclusion.
Results: An ETS of 92.8% was achieved in patients treated with APC and 92.3% for those treated with EFI (P > .05); there was an MRTS improvement of 85.7% in APC patients and 69.2% in EFI patients (P > .05). Mild adverse events occurred, respectively, in 23% and 28.5% in the EFI and APC groups (P > .05).
Conclusions: The study showed that APC and EFI have similar efficacy and a high safety profile for HRP treatment. (Clinical trial registration number: 3.120.353.).
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http://dx.doi.org/10.1016/j.gie.2020.11.007 | DOI Listing |
Gastrointest Endosc
June 2021
Service of Digestive Endoscopy, General Hospital of Fortaleza (affiliated with the Unified Brazilian National Health System), Fortaleza, Brazil.
Background And Aims: Radiotherapy may cause hemorrhagic radiation proctopathy (HRP). For conservative treatment of refractory HRP, argon plasma coagulation (APC) is the first-choice therapy. Endorectal formalin instillation (EFI), in turn, is an attractive treatment option because of its satisfactory results, great availability, and low cost.
View Article and Find Full Text PDFItal J Anat Embryol
April 2006
Section of Anatomy, Department of Human Anatomy and Physiology, University of Padova, Via A Gabelli 65, 35121 Padova, Italy.
The rectovaginal septum (RVS) is described as a strong connective tissue between the rectum and the vagina. The aim of the present study was to investigate the topography and histological structure of the RVS in 20 cadavers (age range: 54-72 years). After in situ formalin fixation, the pelvic viscera and the surrounding connective tissue were removed, together with the pelvic floor.
View Article and Find Full Text PDFUltrasound Q
September 2001
Department of Radiology, State University of New York-Stony Brook, Stony Brook, New York 11794-8460, USA.
The purpose of this article is to assess if the visual inspection of the prostate biopsy specimen can be used as a guide when deciding whether to attempt to sample another core of tissue from the same area if a less than adequate specimen was obtained during the first attempt. Five hundred thirty-seven specimens from 84 patients, referred because of an increased prostate-specific antigen (PSA) level and/or a suspicious result on digital rectal examination (DRE), were sampled and prospectively graded based on the lack of formation and amount of liquid in the specimen (grade I) compared to a highly rigid, solid core (grade V). Specimens were then fixed in formalin and retrospectively compared, and the pathologic diagnosis was compared with the subjective visual grade assigned to the specimen.
View Article and Find Full Text PDFSurg Gynecol Obstet
December 1982
Rectal mucosectomy may be technically difficult to perform on certain patients with severe ulcerative colitis involving the rectum, in whom a colectomy and endorectal ileal pull-through operation is planned. The present study evaluates the effectiveness of the following caustic agents in causing severe injury to the colonic mucosa of dogs after ten minutes of exposure, as determined by light and scanning electron microscopy: 1.0 normal sodium hydroxide; 0.
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