TECHNIQUE OF ARGON PLASMA COAGULATION TREATMENT IN RADIATION PROCTITIS

Abstract

Radiation therapy is increasingly the first choice of treatment for pelvic malignancies such as prostate cancer and uterine cancer. However, radiation colitis is an acute or chronic side effect in the small and large bowels and includes hemorrhagic sigmoid proctitis, ulcer formation, stenosis and fistula. Bloody stool is the most frequent symptom of radiation proctitis (RP). We propose the following classification of RP in order to systematically perform treatment with argon plasma coagulation (APC): Type A, localized telangiectasia; Type B, diffuse telangiectasia; Type C, shallow ulcer or erosion with diffuse telangiectasia, major indication is active bleeding; and Type D, deep ulcer and remarkably fragile mucosa. Four points on the technique of APC treatment are as follows: Ⅰ, Spotting technique; Ⅱ, rinsing well with water to be able to recognize target vessels; Ⅲ, inverting the endoscope to look up the anal canal with a slim scope; Ⅳ, multi-session strategy. Starting from recognizing the classification according to the condition being treated, a long-term hemostatic effect can be obtained based on the treatment strategy, technique of the coagulation method, and judgment of its effect.