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Radiofrequency ablation using BarRx for the endoscopic treatment of radiation proctopathy: a series of three cases

Authors Patel A, Pathak R, Deshpande V, Patel S, Wickremesinghe P, Vadada D

Received 20 April 2014

Accepted for publication 2 October 2014

Published 8 December 2014 Volume 2014:7 Pages 453—460

DOI https://doi.org/10.2147/CEG.S66534

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Andreas M Kaiser


Anish Patel, Rahul Pathak, Vrushak Deshpande, Sunil H Patel, Prasanna C Wickremesinghe, Deepak Vadada

Department of Gastrointestinal Medicine, Richmond University Medical Center, Staten Island, NY, USA

Abstract: Radiation proctopathy is a complication of pelvic radiotherapy, which occurs in patients treated for carcinoma of the prostate, rectum, urinary bladder, cervix, uterus, and testes. If it presents within 6 weeks to 9 months after therapy, it is called acute radiation proctitis/proctopathy (ARP), and if it occurs 9 months to a year after treatment, it is classified as chronic radiation proctitis/proctopathy (CRP). CRP occurs in 5%–20% of patients receiving pelvic radiation, depending on the radiation dose and the presence or absence of chemotherapy. In many cases, CRP resolves spontaneously, but in some, it can lead to persistent rectal bleeding. Other symptoms of CRP include diarrhea, mucoid discharge, urgency, tenesmus, rectal pain, and fecal incontinence. Despite the availability of several therapies, many patients fail to respond, and continue to suffer in their quality of life. Radiofrequency ablation (RFA) is a newer endoscopic technique that uses radiofrequency energy to ablate tissue. This is an emerging way to treat radiation proctopathy and other mucosal telangiectasia. We present three cases of radiation proctopathy treated with RFA at our institute and review the literature on treatment modalities for CRP. We were also able to find 16 other cases of CRP that used RFA, and review their literature as well as literature on other treatment modalities.

Keywords: radiofrequency ablation, radiation proctopathy, BarRx, Halo catheter

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