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Endoscopic diode laser therapy for chronic radiation proctitis.
Lino Polese1,2, Lucia Marini3, Roberto Rizzato3
13rd Surgical Unit, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy. lino.polese@unipd.it.
Lasers in Medical Science
|September 13, 2017
Summary
Endoscopic diode laser therapy effectively treats rectal bleeding from chronic radiation proctitis (CRP). This safe outpatient procedure resolved bleeding in 71% of patients, including those on blood thinners.
Area of Science:
- Gastroenterology
- Oncology
- Radiation Oncology
Background:
- Chronic radiation proctitis (CRP) is a common complication following pelvic radiotherapy, often presenting with debilitating rectal bleeding.
- Managing rectal bleeding in CRP patients can be challenging, particularly in those with comorbidities or on antiplatelet/anticoagulant therapy.
Purpose of the Study:
- To evaluate the efficacy and safety of endoscopic non-contact diode laser therapy for treating rectal bleeding in patients with chronic radiation proctitis.
- To assess treatment outcomes in patients with CRP, including those receiving antiplatelet or anticoagulant medications.
Main Methods:
- Retrospective analysis of 14 patients with CRP and rectal bleeding treated with diode laser therapy between 2010 and 2016.
- Non-contact diode laser fibers were used in an outpatient setting without sedation; patients underwent a median of two sessions.
Main Results:
- Diode laser therapy resolved rectal bleeding in 10 out of 14 patients (71%), with an additional two showing improvement (93% overall response).
- The treatment was safe, with no complications reported during or after procedures. One patient required transfusion post-treatment, having not completed the therapy.
- Treatment was effective even in patients continuing antiplatelet (3 patients) and anticoagulant (2 patients) therapy.
Conclusions:
- Endoscopic non-contact diode laser therapy is a safe and effective treatment option for rectal bleeding caused by chronic radiation proctitis.
- This therapeutic approach offers a viable solution for managing CRP symptoms, even in patients on antithrombotic medications, minimizing the need to suspend crucial therapies.
