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Trans-anal rectoscopic ball diathermy (TARD) for radiotherapy-induced haemorrhagic telangiectasia: a safe and
J C Hopkins1, J J Wood, H Gilbert
1Department of Colorectal Surgery, Cheltenham General Hospital, Cheltenham, UK. jameshopkins@doctors.net.uk
Aim:
Rectal bleeding may occur late after radiotherapy for prostate or bladder cancer, particularly when given by external beam, due to radiotherapy-induced haemorrhagic telangiectasia (RIHT). We present the results of trans-anal rectoscopic ball diathermy (TARD) for RIHT.
Method:
Data were collected from patients who received TARD for RIHT. The diagnosis was made during endoscopic examination. Treatment involved discretely spaced spot monopolar diathermy coagulation of the rectal mucosa to the affected areas.
Results:
Thirteen patients [median age 76 (69-80) years] underwent TARD for RIHT between 2005 and 2008. All presented late with rectal bleeding following radiotherapy for prostate or bladder cancer. Eight were treated as a day case, four remained in hospital for one night and one was hospitalized for 2 days. There was no mortality. Eleven patients achieved excellent symptomatic control requiring no further treatment at a median follow-up of 20 (3-36) months. One patient underwent further TARD for recurrence. One patient complained of severe anorectal pain of no obvious cause and one developed constipation.
Conclusion:
Trans-anal rectoscopic ball diathermy (TARD) is a safe and effective treatment for patients with rectal bleeding due to RIHT.
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