Long-term outcome of argon plasma coagulation therapy for bleeding caused by chronic radiation proctopathy

Dig Liver Dis. 2003 Nov;35(11):806-10. doi: 10.1016/s1590-8658(03)00454-7.


Background: Radiation-induced proctopathy is a serious complication of radiation therapy for pelvic malignancy.

Aim: To assess the safety and efficacy of argon plasma coagulation in the treatment of haemorrhagic radiation-induced proctopathy.

Patients: Twenty-four patients with rectal bleeding due to radiation-induced proctopathy were prospectively enrolled in the study.

Methods: Indications for treatment were iron deficiency anaemia (n = 16) and persistent bleeding, despite pharmacotherapy (n = 8). Argon flow and power used were 0.8-1.2 l/min and 40 W, respectively. An interval of at least 4 weeks was allowed between treatment sessions. Haemoglobin level, bleeding severity score, number of admissions and transfusion requirements were recorded after endoscopic coagulation and before 12 and 24 months.

Results: A median of 2.5 therapeutic sessions per patient were performed (range 1-6). All patients reported clinical improvement and/or cessation of rectal bleeding. The mean value of the bleeding severity score decreased from 2.9 to 0.8 (P < 0.01), while average haemoglobin levels increased by a mean of 1.9 mg/dl at the end of the treatments (P < 0.05). During a minimum follow-up of 24 months (range 24-60), rectal bleeding recurred in two cases and was successfully retreated endoscopically. One patient developed a recto-vaginal fistula.

Conclusions: Argon plasma coagulation appears to be a safe and effective technique for management of rectal bleeding caused by radiation-induced proctopathy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Argon / therapeutic use
  • Carcinoma / radiotherapy
  • Electrocoagulation / adverse effects
  • Electrocoagulation / methods*
  • Female
  • Gastrointestinal Hemorrhage / etiology*
  • Gastrointestinal Hemorrhage / surgery*
  • Hemoglobins / analysis
  • Humans
  • Male
  • Middle Aged
  • Prostatic Neoplasms / radiotherapy
  • Radiotherapy / adverse effects*
  • Rectal Diseases / etiology*
  • Rectal Diseases / surgery*
  • Recurrence
  • Treatment Outcome
  • Uterine Cervical Neoplasms / radiotherapy
  • Uterine Neoplasms / radiotherapy


  • Hemoglobins
  • Argon