Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
Lerner School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Dig Dis Sci. 2018 Sep;63(9):2180-2188. doi: 10.1007/s10620-018-5163-8.
Radiation proctitis is radiation-induced rectal mucositis, occurring as a result of radiation therapy for various pelvic malignancies. The management of radiation proctitis is challenging as guidelines are not currently available, and studies of the various treatment modalities are limited. There are various medical, endoscopic, and surgical measures for treating chronic radiation proctitis. Medical options such as anti-inflammatory agents, antioxidants, formalin application, and hyperbaric oxygen may improve bleeding related to chronic radiation proctitis. Endoscopic measures such as argon plasma coagulation are effective and safe. Surgery is considered for refractory or severe cases. A review and discussion of the different treatment modalities is presented.
放射性直肠炎是由各种盆腔恶性肿瘤放射治疗引起的直肠黏膜炎症。由于目前尚无指南,且各种治疗方式的研究有限,放射性直肠炎的治疗颇具挑战。针对慢性放射性直肠炎,有多种医学、内镜和手术措施。医学手段如抗炎药、抗氧化剂、福尔马林应用和高压氧治疗可能改善与慢性放射性直肠炎相关的出血。内镜手段如氩等离子凝固术安全有效。对于难治性或严重病例,则考虑手术治疗。本文对不同治疗方式进行了回顾和讨论。