Nikfarjam Mehrdad, Faulx Ashley, Laughinghouse Michelle, Marks Jeffrey M
University Hospitals, Case Medical Center, Cleveland, OH 44106, USA.
Surg Innov. 2010 Jun;17(2):92-4. doi: 10.1177/1553350610365701.
Chronic radiation proctitis can be difficult to manage. Radiofrequency ablation has recently been shown to be effective in the management of gastric antral vascular ectasia and Barrett's esophagus, but its utility in the treatment of chronic radiation proctitis is undetermined.
A 77-year-old man with extensive chronic radiation proctitis had continued bleeding despite argon plasma coagulation. The HALO(90) radiofrequency system (BARRX Medical, Sunnyvale, CA) was used for treatment regions of proctitis at an energy density of 12 J/cm(2).
At monthly intervals, over 3 months, radiofrequency ablation was performed with a mean of 7 regions ablated at a time. The mean treatment time was 29 minutes. There was no significant bleeding after the first treatment session. The patient was symptom free at 6 months follow-up with minimal evidence of residual mucosal abnormalities.
Radiofrequency ablation appears feasible for treatment of refractory chronic radiation proctitis, with further studies required.
慢性放射性直肠炎可能难以处理。最近已证明射频消融在治疗胃窦血管扩张症和巴雷特食管方面有效，但其在慢性放射性直肠炎治疗中的效用尚未确定。
一名患有广泛性慢性放射性直肠炎的77岁男性，尽管进行了氩等离子体凝固治疗仍持续出血。使用HALO(90)射频系统（BARRX Medical，加利福尼亚州森尼韦尔市）以12 J/cm²的能量密度对直肠炎治疗区域进行治疗。
在3个月内每月进行一次射频消融，每次平均消融7个区域。平均治疗时间为29分钟。首次治疗后无明显出血。在6个月的随访中患者无症状，残留黏膜异常的证据极少。
射频消融对于难治性慢性放射性直肠炎的治疗似乎可行，但需要进一步研究。
