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二极管激光治疗放射性血管扩张症:长期结果与成本分析

Diode Laser Therapy for Radiation-Induced Vascular Ectasia: Long-Term Results and Cost Analysis.

作者信息

Polese Lino, Giugliano Emilia, Cadrobbi Roberto, Boemo Deris Gianni

机构信息

First Surgical Unit, Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy.

Medical Direction Unit, Padova University Hospital, 35128 Padova, Italy.

出版信息

Life (Basel). 2023 Apr 16;13(4):1025. doi: 10.3390/life13041025.

Abstract

BACKGROUND

Collateral damage to surrounding healthy tissues has been reported in patients who undergo radiation therapy for pelvic malignancies. This study aimed to evaluate the safety, efficacy and cost efficiency of endoscopic diode laser therapy in patients diagnosed with chronic radiation proctitis (CRP).

METHODS

The data of 24 patients (median age 78, range 67-90 years) who presented rectal bleeding and were diagnosed with CRP after undergoing high-dose radiotherapy for prostatic cancer and underwent diode laser therapy were evaluated retrospectively. Non-contact fibers were used in the patients who underwent the procedure without sedation in an outpatient setting.

RESULTS

The patients underwent a median of two sessions; overall, a mean of 1591 J of laser energy per session was used. No complications were noted during or after the procedures. Bleeding was completely resolved in 21/24 (88%) patients, and two patients showed improvement (96%). It was not necessary to suspend antiplatelet (six patients) or anticoagulant (four patients) therapy during the treatment course. The mean cost per session was EUR 473.4.

CONCLUSIONS

The study findings demonstrated that endoscopic non-contact diode laser treatment in CRP patients is safe, effective and cost efficient. For this procedure, antiplatelet and anticoagulant therapy suspension, intraprocedural sedation and hospital admission are not required.

摘要

背景

据报道,接受盆腔恶性肿瘤放射治疗的患者周围健康组织会受到附带损害。本研究旨在评估内镜二极管激光治疗对诊断为慢性放射性直肠炎(CRP)患者的安全性、有效性和成本效益。

方法

回顾性评估24例(中位年龄78岁,范围67 - 90岁)因前列腺癌接受高剂量放疗后出现直肠出血并被诊断为CRP且接受二极管激光治疗患者的数据。在门诊环境中,对未使用镇静剂进行该手术的患者使用非接触光纤。

结果

患者接受的中位治疗次数为两次;总体而言,每次治疗平均使用1591焦耳的激光能量。手术期间或术后未发现并发症。24例患者中有21例(88%)出血完全缓解,2例患者病情改善(96%)。在治疗过程中无需暂停抗血小板治疗(6例患者)或抗凝治疗(4例患者)。每次治疗的平均费用为473.4欧元。

结论

研究结果表明,对CRP患者进行内镜非接触二极管激光治疗是安全、有效且具有成本效益的。对于该手术,无需暂停抗血小板和抗凝治疗、术中镇静及住院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8162/10144337/cf4b73521f0a/life-13-01025-g001.jpg

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