Endoscopic Nd: YAG laser coagulation of bleeding from radiation proctopathy

T. R. Viggiano, J. Zighelboim, D. A. Ahlquist, C. J. Gostout, Kenneth Ke Ning Wang, M. V. Larson

Research output: Contribution to journalArticle

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Abstract

Hematochezia from mucosal vascular lesions usually confined to the rectum represents an uncommon but problematic late complication of pelvic radiotherapy. We studied 47 patients with medically refractory hematochezia resulting from radiation-induced rectosigmoid mucosal vascular lesions. All lesions were endoscopically coagulated with Nd:YAG laser. Median duration of hematochezia before laser therapy was 11 months, despite previous medical treatment (98%) or bypass colostomy (6%). Within 3 to 6 months after laser treatment, the number of patients with daily hematochezia fell from 40 (85%) to 5 (11%; p < 0.001), and the median hemoglobin level increased from 9.7 gm/dl to 11.7 gm/dl (p < 0.001). Complications occurred in three patients (6%); no deaths occurred. The condition in six patients (12.8%) was not improved by laser treatment. Two patients (4%) ultimately required surgical treatment for bleeding control. On the basis of symptomatic, hematologic, and endoscopic responses, Nd:YAG laser photocoagulation controlled bleeding from radiation proctopathy in most patients with an acceptably low morbidity. Patients with sigmoid colon involvement responded less favorably. Endoscopic laser photocoagulation should be considered before surgical intervention for treatment of hematochezia from radiation proctopathy.

Original languageEnglish (US)
Pages (from-to)513-517
Number of pages5
JournalGastrointestinal Endoscopy
Volume39
Issue number4
StatePublished - 1993

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Laser Coagulation
Solid-State Lasers
Gastrointestinal Hemorrhage
Radiation
Hemorrhage
Lasers
Light Coagulation
Blood Vessels
Therapeutics
Colostomy
Laser Therapy
Sigmoid Colon
Rectum
Hemoglobins
Radiotherapy
Morbidity

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Viggiano, T. R., Zighelboim, J., Ahlquist, D. A., Gostout, C. J., Wang, K. K. N., & Larson, M. V. (1993). Endoscopic Nd: YAG laser coagulation of bleeding from radiation proctopathy. Gastrointestinal Endoscopy, 39(4), 513-517.

Endoscopic Nd : YAG laser coagulation of bleeding from radiation proctopathy. / Viggiano, T. R.; Zighelboim, J.; Ahlquist, D. A.; Gostout, C. J.; Wang, Kenneth Ke Ning; Larson, M. V.

In: Gastrointestinal Endoscopy, Vol. 39, No. 4, 1993, p. 513-517.

Research output: Contribution to journalArticle

Viggiano, TR, Zighelboim, J, Ahlquist, DA, Gostout, CJ, Wang, KKN & Larson, MV 1993, 'Endoscopic Nd: YAG laser coagulation of bleeding from radiation proctopathy', Gastrointestinal Endoscopy, vol. 39, no. 4, pp. 513-517.
Viggiano TR, Zighelboim J, Ahlquist DA, Gostout CJ, Wang KKN, Larson MV. Endoscopic Nd: YAG laser coagulation of bleeding from radiation proctopathy. Gastrointestinal Endoscopy. 1993;39(4):513-517.
Viggiano, T. R. ; Zighelboim, J. ; Ahlquist, D. A. ; Gostout, C. J. ; Wang, Kenneth Ke Ning ; Larson, M. V. / Endoscopic Nd : YAG laser coagulation of bleeding from radiation proctopathy. In: Gastrointestinal Endoscopy. 1993 ; Vol. 39, No. 4. pp. 513-517.
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