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慢性放射性直肠炎的射频消融治疗:我们的4例初步经验。

Radiofrequency ablation for chronic radiation proctitis: our initial experience with four cases.

作者信息

Pigò F, Bertani H, Manno M, Mirante V G, Caruso A, Conigliaro R L

机构信息

Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Modena, Italy,

出版信息

Tech Coloproctol. 2014 Nov;18(11):1089-92. doi: 10.1007/s10151-014-1178-0. Epub 2014 Jun 11.

Abstract

BACKGROUND

Chronic radiation proctitis (CRP) occurs up to 20 % of patients after pelvic radiotherapy, with rectal bleeding as the main presenting complaint. Radiofrequency ablation (RFA) has recently been used in the management of Barrett's esophagus, but its efficacy in CRP has to be studied. The aim of this case series was to describe four cases of patients with CRP treated with RFA that demonstrate the efficacy and safety of the technique.

METHODS

All the procedures were performed with HALO 90 or HALO 90 Ultra ablation catheter fitted on the distal end of a standard flexible endoscope. For each patient, the severity of symptoms was assessed at baseline and after the last treatment session.

RESULTS

At least two sessions of RFA (maximum 4) were necessary, at three-month intervals, to completely control the symptoms. No major complications were observed.

CONCLUSIONS

RFA was effective and safe for control bleeding in this case series. Adequately powered randomized controlled trials are needed to establish the safety and efficacy of RFA for CRP.

摘要

背景

盆腔放疗后高达20%的患者会发生慢性放射性直肠炎(CRP),主要表现为直肠出血。射频消融(RFA)最近已用于巴雷特食管的治疗,但其在CRP中的疗效尚待研究。本病例系列的目的是描述4例接受RFA治疗的CRP患者,以证明该技术的有效性和安全性。

方法

所有操作均使用安装在标准软性内窥镜远端的HALO 90或HALO 90 Ultra消融导管进行。对每位患者在基线和最后一次治疗后评估症状的严重程度。

结果

至少需要进行两疗程(最多4疗程)的RFA,间隔3个月,以完全控制症状。未观察到重大并发症。

结论

在本病例系列中,RFA对控制出血有效且安全。需要进行足够样本量的随机对照试验来确定RFA治疗CRP的安全性和有效性。

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