Endoscopic Laser Coagulation of Radiation‐Induced Mucosal Vascular Lesions in the Upper Gastrointestinal Tract and Proximal Colon

Jaime Zighelboim, Thomas R. Viggiano, David A. Ahlquist, Christopher J. Gostout, Kenneth K. Wang, Mark V. Larson

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Endoscopic laser coagulation effectively controls bleeding from radiation‐induced rectal vascular lesions. Objective: To assess the outcome of endoscopic treatment of radiation‐induced bleeding due to vascular lesions located proximal to the sigmoid colon. Methods: We identified 15 consecutive patients with such proximal radiation enteropathy treated at our Institution with Nd:YAG laser between 1984 and 1991. Ten patients (66%) had gastric and/or small bowel involvement, and five (33%) had colonic involvement with or without more proximal lesions. Bleeding first appeared at a mean of 21.2 ± 12.5 months after completion of radiotherapy. Mean duration of gastrointestinal bleeding before laser treatment was 7.6 ± 4.6 months. Results: After completion of laser therapy, bleeding ceased in nine (60%) patients, decreased in three (20%), and persisted in three (20%). The mean hemoglobin level increased from 8.4 ± 0.5 g/dl to 10.4 ± 0.6 g/dl after completion of laser treatments (p < 0.02). The mean number of transfusions per patient per year decreased from 10.5 ± 2.8 to 0.9 ± 0.7 (p < 0.01). No treatment‐related complications or deaths occurred. Conclusions: Endoscopic laser coagulation of radiation‐induced mucosal vascular lesions in the upper gastrointestinal tract and proximal colon appears to be safe and, in most cases, effective.

Original languageEnglish (US)
Pages (from-to)1224-1227
Number of pages4
JournalThe American Journal of Gastroenterology
Volume88
Issue number8
DOIs
StatePublished - Aug 1993

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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