Radiation therapy is part of the complex treatment of pelvic neoplasms, but it has several complications, such as chronic radiation proctitis. Frequent rectal bleeding is common in these patients due to telangiectasias. Argon plasma coagulation (APC) is a safe and affordable treatment for chronic radiation proctitis.

OBJECTIVE

We developed a technique to use APC to treat rectal bleeding in patients with radiation proctitis and assessed its effectiveness and safety.

MATERIALS AND METHODS

The study’s inclusion criteria were grade 2—3 chronic proctitis according to the RTOG/EORC radiation proctitis severity scale; rectal bleeding often requiring blood transfusion; ineffective conservative therapy with 5-aminosalicylic acid and rectal steroids for 30 days. To stop bleeding, all patients underwent APC of rectal mucosa with telangiectasias. We assessed several intraoperative parameters: duration of the operation, blood loss volume, intraoperative complications frequency.

RESULTS

The study included 13 patients (7 women and 6 men) who underwent APC of the rectal mucosa. The average age was 69.38±2.59 years. All patients had concomitant diseases of the cardiovascular system and had II—III risk degree of surgical and anesthetic complications according to the ASA scale. In 84.6% of patients, no rectal bleeding reoccurred three months after the operation. In all patients on control rectoscopy after three months, a decrease or complete disappearance of telangiectasias in the rectum was noted.

CONCLUSION

APC is a safe, effective, and affordable method for treating chronic radiation proctitis complicated by recurrent rectal bleeding.