RESUMEN
INTRODUCTION: There are two kinds of actinic proctitis--one is acute and self-limited, and lasts about 3 months; the other is chronic and develops months to years after radiation therapy. The incidence of chronic actinic proctitis is about 5-20% of radiated prostate tumors. OBJECTIVE: To evaluate the effectiveness of argon plasma coagulation in the treatment of chronic actinic proctitis. MATERIAL AND METHOD: A retrospective search of patients with the diagnosis of actinic proctitis. The number of argon plasma coagulation therapies needed to achieve the symptom resolution was analyzed. RESULTS: We found 22 patients with a diagnosis of actinic proctitis. Nineteen were males (86.7%) and three (13.6%) were females. Nineteen patients (86.4%) had a diagnosis of prostate adenocarcinoma, one had a diagnosis of squamous-cell cervix carcinoma (4.5%), and two had a diagnosis of endometrial carcinoma (9.1%). The mean number of coagulation sessions needed for symptom resolution was 2.58 (absolute range 1-7) with a median of 2 sessions. CONCLUSION: Multiple treatments are described in the literature. None of them have shown promising results. Our results suggest that argon plasma coagulation is effective in the treatment of this condition, and achieves a rapid and sustained response with few sessions and a good safety profile.
Asunto(s)
Hemorragia Gastrointestinal/cirugía , Coagulación con Láser , Proctitis/cirugía , Traumatismos por Radiación/cirugía , Adenocarcinoma/radioterapia , Anciano , Argón , Carcinoma de Células Escamosas/radioterapia , Femenino , Hemorragia Gastrointestinal/etiología , Hemostasis Quirúrgica/instrumentación , Humanos , Masculino , Proctitis/complicaciones , Neoplasias de la Próstata/radioterapia , Traumatismos por Radiación/complicaciones , Estudios Retrospectivos , Resultado del Tratamiento , Neoplasias del Cuello Uterino/radioterapia , Neoplasias Uterinas/radioterapiaRESUMEN
Introducción: existen 2 tipos de proctitis actínica, una aguda autolimitada, que dura aproximadamente 3 meses y otra crónica que aparece a los meses o años de la radioterapia. La incidencia de proctitis actínica crónica es del 5-20% de los tumores prostáticos irradiados. Objetivo: evaluar la efectividad de la fulguración con argón plasma en el tratamiento de este tipo de proctitis. Material y método: estudio retrospectivo. Realizamos una búsqueda retrospectiva de aquellos pacientes diagnosticados de proctitis actínica entre 2004 y 2007. Analizamos el número de sesiones de fulguración con plasma de argón que fueron necesarias para la resolución de la sintomatología. Resultados: hemos hallado 22 pacientes con el diagnóstico de proctitis actínica. Diecinueve de los pacientes eran varones (86,4%) y tres mujeres (13,6%). De todos los pacientes 19 fueron diagnosticados de adenocarcinoma prostático (86,4%), una fue diagnosticada de carcinoma epidermoide de cérvix uterino (4,5%) y dos fueron diagnosticadas de adenocarcinoma de endometrio (9,1%). La media de sesiones de fulguración con plasma de argón necesarias para resolución de la clínica presentada fue de 2,58 (rango entre 1 y 7 sesiones) y con un mediana de 2 sesiones. Conclusión: en la literatura hay descritos múltiples tratamientos para la proctitis actínica. No obstante, ninguno de ellos ha presentado resultados demasiado prometedores. Nuestros resultados sugieren que la fulguración con plasma de argón es efectiva en el tratamiento de esta patología, consiguiendo una resolución rápida y mantenida de la sintomatología con pocas sesiones, además de presentar un buen perfil de seguridad(AU)
Introduction: there are two kinds of actinic proctitis - one is acute and self-limited, and lasts about 3 months; the other is chronic and develops months to years after radiation therapy. The incidence of chronic actinic proctitis is about 5-20% of radiated prostate tumors. Objective: to evaluate the effectiveness of argon plasma coagulation in the treatment of chronic actinic proctitis. Material and method: a retrospective search of patients with the diagnosis of actinic proctitis. The number of argon plasma coagulation therapies needed to achieve the symptom resolution was analyzed. Results: we found 22 patients with a diagnosis of actinic proctitis. Nineteen were males (86.7%) and three (13.6%) were females. Nineteen patients (86.4%) had a diagnosis of prostate adenocarcinoma, one had a diagnosis of squamous-cell cervix carcinoma (4.5%), and two had a diagnosis of endometrial carcinoma (9.1%). The mean number of coagulation sessions needed for symptom resolution was 2.58 (absolute range 1-7) with a median of 2 sessions. Conclusion: multiple treatments are described in the literature. None of them have shown promising results. Our results suggest that argon plasma coagulation is effective in the treatment of this condition, and achieves a rapid and sustained response with few sessions and a good safety profile(AU)
