Efficacy and safety of Nd:YAG laser for the treatment of bleeding from radiation proctocolitis

Background. Bleeding due to radiation proctocolitis is a frequent and severe complication of radiotherapy in cancers of the pelvis. Aim. The aim of this study was to evaluate the efficacy and safety of endoscopic treatment with Nd:YAG laser in this condition. Patients and Methods. A series of 9 patients with radiation-induced damage in the rectum and sigma were treated with endoscopic Nd:YAG laser until significant bleeding stopped and endoscopic features of proctocolitis improved. They received a median of 3 laser treatments(range 1-10) over a maximum time period of 11 months. Results. In 4 cases, bleeding ceased and, in 4, it was reduced to occasional spotting. In the remaining patient, laser therapy led to only a transient improvement, but did not modify the requirement of blood transfusion. In the 5 patients also suffering from urgency, incontinence and/or rectal mucoid discharge, the laser therapy course also relieved these symptoms. No significant treatment-related complications were observed. Conclusions. Endoscopic Nd:YAG laser is a useful and safe treatment for patients with bleeding due to radiation proctocolitis.