Effective treatment of chronic radiation proctitis using radiofrequency ablation

Chao Zhou; Desmond C. Adler; Yu Chen; Tsung Han Tsai; James G. Fujimoto; Laren Becker; Marisa Figueiredo; Hiroshi Mashimo; Joseph M. Schmitt

doi:10.1177/1756283X08103341

Effective treatment of chronic radiation proctitis using radiofrequency ablation

Chao Zhou, Desmond C. Adler, Yu Chen, Tsung Han Tsai, James G. Fujimoto, Laren Becker, Marisa Figueiredo, Hiroshi Mashimo, Joseph M. Schmitt

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73 Scopus citations

Abstract

Endoscopic argon plasma coagulation and bipolar electrocautery are currently preferred treatments for chronic radiation proctitis, but ulcerations and strictures frequently occur. Radiofrequency ablation (RFA) has been successful for mucosal ablation in the esophagus. Here we report the efficacy of RFA with the BarRx Halo⁹⁰ system in three patients with bleeding from chronic radiation proctitis. In all cases, the procedure was well tolerated and hemostasis was achieved after 1 or 2 RFA sessions. Re-epithelialization of squamous mucosa was observed over areas of prior hemorrhage. No stricturing or ulceration was seen on follow-up up to 19 months after RFA treatment. Real-time endoscopic optical coherence tomography (EOCT) visualized epithelialization and subsurface tissue microvasculature pre- and post-treatment, demonstrating its potential for follow-up assessment of endoscopic therapies.

Original language	English
Pages (from-to)	149-156
Number of pages	8
Journal	Therapeutic Advances in Gastroenterology
Volume	2
Issue number	3
DOIs	https://doi.org/10.1177/1756283X08103341
State	Published - May 2009

Keywords

Chronic radiation proctitis
Endoscopic optical coherence tomography (EOCT)
Endoscopic therapy
Lower gastrointestinal bleeding
Radiofrequency ablation (RFA)

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10.1177/1756283X08103341

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title = "Effective treatment of chronic radiation proctitis using radiofrequency ablation",

abstract = "Endoscopic argon plasma coagulation and bipolar electrocautery are currently preferred treatments for chronic radiation proctitis, but ulcerations and strictures frequently occur. Radiofrequency ablation (RFA) has been successful for mucosal ablation in the esophagus. Here we report the efficacy of RFA with the BarRx Halo90 system in three patients with bleeding from chronic radiation proctitis. In all cases, the procedure was well tolerated and hemostasis was achieved after 1 or 2 RFA sessions. Re-epithelialization of squamous mucosa was observed over areas of prior hemorrhage. No stricturing or ulceration was seen on follow-up up to 19 months after RFA treatment. Real-time endoscopic optical coherence tomography (EOCT) visualized epithelialization and subsurface tissue microvasculature pre- and post-treatment, demonstrating its potential for follow-up assessment of endoscopic therapies.",

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AU - Zhou, Chao

AU - Adler, Desmond C.

AU - Chen, Yu

AU - Tsai, Tsung Han

AU - Fujimoto, James G.

AU - Becker, Laren

AU - Figueiredo, Marisa

AU - Mashimo, Hiroshi

AU - Schmitt, Joseph M.

PY - 2009/5

Y1 - 2009/5

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AB - Endoscopic argon plasma coagulation and bipolar electrocautery are currently preferred treatments for chronic radiation proctitis, but ulcerations and strictures frequently occur. Radiofrequency ablation (RFA) has been successful for mucosal ablation in the esophagus. Here we report the efficacy of RFA with the BarRx Halo90 system in three patients with bleeding from chronic radiation proctitis. In all cases, the procedure was well tolerated and hemostasis was achieved after 1 or 2 RFA sessions. Re-epithelialization of squamous mucosa was observed over areas of prior hemorrhage. No stricturing or ulceration was seen on follow-up up to 19 months after RFA treatment. Real-time endoscopic optical coherence tomography (EOCT) visualized epithelialization and subsurface tissue microvasculature pre- and post-treatment, demonstrating its potential for follow-up assessment of endoscopic therapies.

KW - Chronic radiation proctitis

KW - Endoscopic optical coherence tomography (EOCT)

KW - Endoscopic therapy

KW - Lower gastrointestinal bleeding

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Effective treatment of chronic radiation proctitis using radiofrequency ablation

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Keywords

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