Gastrointestinal Cancer Research Group, Department of Surgery, University of KwaZulu-Natal, South Africa.
Gastrointestinal Cancer Research Group, Department of Surgery, University of KwaZulu-Natal, South Africa and Department of Global Health, Stellenbosch University, South Africa.
S Afr J Surg. 2023 Mar;61(1):17-20.
Haemorrhagic radiation proctitis occurs in 5-10% of patients undergoing radiotherapy. In our resourceconstrained South African setting, this study aimed to describe the clinicopathological spectrum and management of radiation proctitis referred to a tertiary centre, to address the deficit in our setting-specific understanding of the condition.
This was a sub-analysis of data from an existing colorectal cancer registry at the Inkosi Albert Luthuli Central Hospital in Durban. We reviewed the registry for all patients between 2008 and 2019 with haemorrhagic radiation proctitis and describe the various patient characteristics, treatments and outcomes for these patients.
Fifty-eight patients with haemorrhagic radiation proctitis were identified. Colonoscopy findings included bleeding (58 patients), endoscopic proctitis (30 patients) and rectal stricture (7 patients). The median time elapsed between radiotherapy and development of symptoms was 16.5 months (IQR 12-25). Median number of argon plasma coagulation (APC) sessions for endoscopic healing or symptom resolution was three sessions (IQR 2-4). At follow-up, 35 patients had complete healing and 19 patients had symptom improvement. Complications occurring during or after APC therapy included rectal ulceration (2 patients) and rectovaginal fistula (1 patient).
APC is a safe and effective treatment modality with complete resolution or significant improvement in symptomatology in the vast majority of patients with three or four treatments. Morbidity is likely to be related to ongoing radiation effects.
放射治疗后 5-10%的患者会发生出血性放射性直肠炎。在我们资源有限的南非环境下，本研究旨在描述三级中心转诊的放射性直肠炎的临床病理谱和管理，以解决我们对该疾病的特定于环境的理解不足的问题。
这是德班英科西·阿尔伯特·卢图利中央医院现有结直肠癌登记处数据的子分析。我们对该登记处 2008 年至 2019 年间所有患有出血性放射性直肠炎的患者进行了回顾，描述了这些患者的各种患者特征、治疗方法和结果。
确定了 58 例出血性放射性直肠炎患者。结肠镜检查结果包括出血（58 例）、内镜直肠炎（30 例）和直肠狭窄（7 例）。放疗后出现症状的时间中位数为 16.5 个月（IQR 12-25）。内镜愈合或症状缓解的氩等离子凝固（APC）治疗中位数为 3 次（IQR 2-4）。随访时，35 例患者完全愈合，19 例患者症状改善。APC 治疗期间或之后发生的并发症包括直肠溃疡（2 例）和直肠阴道瘘（1 例）。
APC 是一种安全有效的治疗方法，大多数患者接受三到四次治疗后症状完全缓解或明显改善。发病率可能与持续的放射效应有关。
