Endoscopic and non-endoscopic approaches for the management of radiation-induced rectal bleeding

被引:0
|
作者
Joseph Paul Weiner [1 ,2 ]
Andrew Thomas Wong [1 ,2 ]
David Schwartz [1 ,2 ]
Manuel Martinez [3 ,4 ]
Ayse Aytaman [3 ]
David Schreiber [1 ,2 ]
机构
[1] Department of Radiation Oncology, VA NY Harbor Healthcare System, Brooklyn Campus
[2] Department of Radiation Oncology, SUNY Downstate Medical Center
[3] Department of Gastroenterology, SUNY Downstate Medical Center
[4] Department of Gastro-enterology, VA NY Harbor Healthcare System, Brooklyn Campus
关键词
Prostate cancer; Radiation therapy; Radiation proctitis; Radiation proctopathy; Medical treatment; Endoscopic treatment; Hyperbaric oxygen; Neodymium/ yttrium aluminum garnet argon laser; Argon plasma coagulation;
D O I
暂无
中图分类号
R737.25 [前列腺肿瘤]; R730.55 [放射疗法];
学科分类号
100105 ; 100214 ;
摘要
Pelvic radiation is a commonly utilized treatment for malignancy of the genitourinary and lower gastrointestinal tract. Radiation proctitis and the resultant clinical picture varies from asymptomatic to potentially life threatening. Similarly, treatment options also vary greatly, from medical therapy to surgical intervention. Commonly utilized medical therapy includes sucralfate enemas, antibiotics, 5-aminosalicylic acid derivatives, probiotics, antioxidants, short-chain fatty acids, formalin instillation and fractionated hyperbaric oxygen. More invasive treatments include endoscopic-based, focally ablative interventions such as dilation, heater and bipolar cautery, neodymium/yttrium aluminum garnet argon laser, radiofrequency ablation or argon plasma coagulation. Despite its relatively common frequency, there is a dearth of existing literature reporting headto-head comparisons of the various treatment options via a randomized controlled approach. The purpose of our review was to present the reader a consolidation of the existing evidence-based literature with the goal of highlighting the comparative effectiveness and risks of the various treatment approaches. Finally, we outline a pragmatic approach to the treatment of radiation proctitis. In light of the lack of randomized data, our goal is to pursue as least invasive an approach as possible, with escalation of care tailored to the severity of the patient’s symptoms. For those cases that are clinicallyasymptomatic or only mildly symptomatic, observation or medical management can be considered. Once a patient fails such management or symptoms become more severe, invasive procedures such as endoscopically based focal ablation or surgical intervention can be considered. Although not all recommendations are supported by level I evidence, reported case series and single-institutional studies in the literature suggest that successful treatment with cessation of symptoms can be obtained in the majority of cases.
引用
收藏
页码:6972 / 6986
页数:15
相关论文
共 50 条
  • [31] Non-endoscopic tests in the diagnosis of Helicobacter pylori infection
    Atherton, JC
    ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 1997, 11 : 11 - 20
  • [32] TOLERABILITY OF A NON-ENDOSCOPIC DISTAL ESOPHAGUS SAMPLING DEVICE
    Alaber, Omar A.
    Chandar, Apoorva K.
    Brock, Wendy
    Dumot, John A.
    Faulx, Ashley L.
    Thota, Prashanthi N.
    Canto, Marcia I.
    Iyer, Prasad G.
    Wang, Jean S.
    Shaheen, Nicholas J.
    Kumar, Mythri Anil
    Cosby, Hilary
    Lansing, Ramona
    Hollander, Thomas
    Ofori-Marfoh, Yaa
    Watts, Ariel E.
    Gawel, Roxanne
    Moinova, Helen
    Lutterbaugh, James
    Barnholtz-Sloan, Jill
    Willis, Joseph
    Markowitz, Sanford D.
    Chak, Amitabh
    GASTROENTEROLOGY, 2020, 158 (06) : S310 - S310
  • [33] Pediatric multicenter cohort comparison of percutaneous endoscopic and non-endoscopic gastrostomy technique outcomes
    Kumar, Ashwath S.
    Yaghoub, Majid Bani
    Rekab, Kamel
    Hall, Matt
    Attard, Thomas Mario
    JOURNAL OF INVESTIGATIVE MEDICINE, 2020, 68 (02) : 413 - 418
  • [34] A comparison of endoscopic and non-endoscopic biliary intervention outcomes in patients with prior bariatric surgery
    Kamboj, Amrit K.
    Pidlaoan, Victorio
    Shakhatreh, Mohammad H.
    Hinton, Alice
    Conwell, Darwin L.
    Krishna, Somashekar G.
    ENDOSCOPY INTERNATIONAL OPEN, 2018, 6 (01) : E11 - E28
  • [35] BILE REFLUX PREDICTION BY NON-ENDOSCOPIC CLINICAL FACTORS
    Tabbaa, Mumtaz G.
    Lim, Sean
    GASTROENTEROLOGY, 2022, 162 (07) : S546 - S547
  • [36] Endoscopic management of intraprocedural bleeding during endoscopic interventions
    Alali, Ali A.
    Alkandari, Asma A.
    BEST PRACTICE & RESEARCH CLINICAL GASTROENTEROLOGY, 2024, 69
  • [37] Gastroesophageal reflux in children: indications of non-endoscopic investigations
    Viola, S
    Tounian, P
    ARCHIVES DE PEDIATRIE, 2004, 11 (06): : 668 - 670
  • [38] Endoscopic approaches to upper gastrointestinal bleeding
    Stiegmann, GV
    AMERICAN SURGEON, 2006, 72 (02) : 111 - 115
  • [39] Identification of Non-Endoscopic Predictors of Esophageal Varices in Cirrhosis
    Shah, Zahid Hussain
    Sarwar, Shahid
    Saleem, Khurram
    Abaidullah, Sajid
    Mehboob, Fatima
    Afzal, Aurangzeb
    Arshad, Zunaira
    PAKISTAN JOURNAL OF MEDICAL & HEALTH SCIENCES, 2011, 5 (02): : 257 - 261
  • [40] Rectal bleeding in children: endoscopic evaluation revisited
    de Ridder, Lissy
    van Lingen, Anna V.
    Taminiau, Jan A. J. M.
    Benninga, Marc A.
    EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 2007, 19 (04) : 317 - 320