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内镜下二极管激光治疗慢性放射性直肠炎。

Endoscopic diode laser therapy for chronic radiation proctitis.

作者信息

Polese Lino, Marini Lucia, Rizzato Roberto, Picardi Edgardo, Merigliano Stefano

机构信息

3rd Surgical Unit, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy.

Clinica Chirurgica 3, Policlinico Universitario, 6° Piano, Via Giustiniani 2, 35128, Padua, Italy.

出版信息

Lasers Med Sci. 2018 Jan;33(1):35-39. doi: 10.1007/s10103-017-2323-6. Epub 2017 Sep 11.

Abstract

The purpose of this study is to determine the effectiveness of endoscopic diode laser therapy in patients presenting rectal bleeding due to chronic radiation proctitis (CRP). A retrospective analysis of CRP patients who underwent diode laser therapy in a single institution between 2010 and 2016 was carried out. The patients were treated by non-contact fibers without sedation in an outpatient setting. Fourteen patients (median age 77, range 73-87 years) diagnosed with CRP who had undergone high-dose radiotherapy for prostatic cancer and who presented with rectal bleeding were included. Six required blood transfusions. Antiplatelet (three patients) and anticoagulant (two patients) therapy was not suspended during the treatments. The patients underwent a median of two sessions; overall, a mean of 1684 J of laser energy per session was used. Bleeding was resolved in 10/14 (71%) patients, and other two patients showed improvement (93%). Only one patient, who did not complete the treatment, required blood transfusions after laser therapy; no complications were noted during or after the procedures. Study findings demonstrated that endoscopic non-contact diode laser treatment is safe and effective in CRP patients, even in those receiving antiplatelet and/or anticoagulant therapy.

摘要

本研究的目的是确定内镜二极管激光疗法对因慢性放射性直肠炎(CRP)出现直肠出血的患者的有效性。对2010年至2016年期间在单一机构接受二极管激光治疗的CRP患者进行了回顾性分析。患者在门诊环境中采用无镇静的非接触光纤进行治疗。纳入了14例诊断为CRP的患者,这些患者因前列腺癌接受了高剂量放疗并出现直肠出血。其中6例需要输血。治疗期间未停用抗血小板治疗(3例患者)和抗凝治疗(2例患者)。患者接受的治疗次数中位数为2次;总体而言,每次治疗平均使用1684焦耳的激光能量。10/14(71%)的患者出血得到解决,另外2例患者病情有所改善(93%)。只有1例未完成治疗的患者在激光治疗后需要输血;治疗期间及治疗后均未观察到并发症。研究结果表明,内镜非接触二极管激光治疗对CRP患者是安全有效的,即使是那些正在接受抗血小板和/或抗凝治疗的患者。

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