Department of Physiology and Pathophysiology, Faculty of Medicine, University of Ostrava, Ostrava Syllabova 19, Ostrava Vitkovice, 70030, Czech Republic.
Unit of Endoscopic Surgery, Department of Surgery, University of Campania "Luigi Vanvitelli", 80131, Naples, Italy.
Dig Dis Sci. 2024 Sep;69(9):3147-3155. doi: 10.1007/s10620-024-08553-z. Epub 2024 Jul 15.
Chronic radiation proctitis, although relatively rare, can be the source of severe comorbidity in patients who had undergone prior radiotherapy for pelvic malignancy. Although current treatments for radiation proctitis include argon plasma coagulation, heater probe, bipolar neodymium/yttrium aluminum garnet (Nd: YAG) lasers, these interventions are often burdened by the frequent occurrence of rectal ulcerations and stenosis. Since radiofrequency ablation (RFA) is frequently used to ablate esophageal malignancy and pre-malignancy, we report the efficacy of RFA using through the scope system in two patients with rectal bleeding due to radiation proctitis. In both cases, the procedure was well-tolerated with hemostasis achieved after 1 or 2 sessions of RFA. Mucosal re-epithelialization was observed in areas of previous bleeding with no stenosis or ulceration observed at follow-up.
慢性放射性直肠炎虽然相对少见，但可能是既往盆腔恶性肿瘤放疗后发生严重并发症的根源。目前放射性直肠炎的治疗方法包括氩等离子凝固术、热探头、双极钕/钇铝石榴石（Nd:YAG）激光等，但这些干预措施常因直肠溃疡和狭窄频繁发生而受到困扰。由于射频消融（RFA）常用于消融食管恶性肿瘤及其癌前病变，我们报告了通过内镜系统在两名因放射性直肠炎导致直肠出血的患者中使用 RFA 的疗效。在这两种情况下，该操作均耐受良好，1-2 次 RFA 后即可止血。在先前出血部位观察到黏膜再上皮化，随访时未观察到狭窄或溃疡。
