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Gastroenterol Res Pract. 2018 Feb 25;2018:3087603. doi: 10.1155/2018/3087603. eCollection 2018.

Efficacy and Safety of Argon Plasma Coagulation for Hemorrhagic Chronic Radiation Proctopathy: A Systematic Review.

Peng Y1,2, Wang H1,2, Feng J1,2, Fang S1,2, Zhang M1,2, Wang F1,2, Chang Y1,2, Shi X1,2, Zhao Q1,2, Liu J1,2.

Author information

1
Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China.
2
Hubei Clinical Center and Key Lab of Intestinal and Colorectal Diseases, Wuhan, China.

Abstract

Hemorrhagic chronic radiation proctopathy (CRP) is a common complication after pelvic radiotherapy in patients with prostate or gynecological cancers. This systematic review was conducted to evaluate the efficacy and safety of argon plasma coagulation (APC) in treating hemorrhagic CRP. The databases of PubMed, Embase, and Cochrane Library were searched for related studies from inception to July 2017. Finally, 33 studies were identified with a total of 821 hemorrhagic CRP patients. After APC treatment, hemoglobin levels increased from 7.7-13.4 g/L to 11-14 g/L (including 15 studies). All (n = 33) studies reported an effective rate in rectal bleeding, among which five studies had a rate of 100%. Short-term complications were reported in 31 studies, while long-term complications in 33 studies and no complication in 11 studies. As for the severe complications, perforation was reported by 2 out of 33 studies, and the incidences were 3.3% (1/30) and 3.7% (1/27), respectively. As for APC setting, argon gas flow rate (median 1.5 L/min) and electric power (median 50 W) had no significant influence on complications and hemostasis. In conclusion, current literature indicated that APC therapy was an effective and safe strategy for hemorrhagic CRP, and large-scale prospective studies are needed to warrant our study.

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