ARGONOPLASMIC COAGULATION IN THE TREATMENT OF CHRONIC RADIATION PROCTITIS COMPLICATED BY BLEEDING

Rationale : Chronic radiation proctitis is a complication of remote radiation therapy used to treat malignant neoplasms of the pelvis, and is often complicated by the development of rectal bleeding. Argonoplasmic coagulation is one of the available endoscopic methods of their treatment, but the effectiveness of its use needs to be studied. Objective: To evaluate the effectiveness of endoscopic argonoplasmic coagulation to eliminate telangiectasias of the rectal mucosa in patients with chronic radiation proctitis complicated by bleeding, and to present a sectoral classification of lesions of the rectal mucosa with telangiectasias. Methods : The article presents the results of treatment of 18 patients with chronic radiation proctitis who underwent argonoplasmic coagulation of telangiectasias of the mucous membrane of the rectum in order to stop bleeding and prevent their occurrence. To assess the effectiveness of treatment, a sectoral classification of the rectal lesion was applied. Results : After argonoplasmic coagulation of telangiectasia of the rectal mucosa, all patients had no rectal bleeding for 6 months. In 13 (72%) patients, there was a sharp decrease in the frequency of blood excretion during defecation, in the remaining 5 (28%) patients there was no blood excretion from the rectum. In the postoperative period, two recurrence of bleeding from the treatment site was observed on the second and seventh days of the postoperative period, which required repeated application of argonoplasmic coagulation. Conclusion : Endoscopic argonoplasmic coagulation is effective in eliminating telangiectasia in patients with chronic radiation proctitis complicated by bleeding. The presented sectoral classification of rectal lesions in chronic radiation proctitis is convenient to use and contributes to the assessment of changes in the mucous membrane of the rectum in dynamics.