KTP laser therapy for bleeding from chronic radiation proctopathy.

Abstract

BACKGROUND:

Endoscopic laser photocoagulation is commonly used to treat bleeding from the neovascular lesions of chronic radiation proctopathy. The KTP laser is an Nd/YAG-driven unit that emits light with a wavelength of 532 nm. This wavelength of energy is absorbed by hemoglobin and penetrates tissue to a depth of only 1 to 2 mm.

METHODS:

Twenty-three patients were treated with KTP laser and followed for a median of 29 months (range 5 to 51 months); 21 had received radiation for prostate cancer and 2 for uterine cancer. The median age was 77 years (range 68 to 87 years). A median of 2 sessions (range 1 to 5 sessions) was performed using 4 to 10 Watts of power and a median energy of 816 Joules per session (range 204 to 2430 Joules).

RESULTS:

After treatment there was a significant reduction in the frequency (p = 0.0005) of bleeding, increase in hematocrit level (p < 0.0001), improvement in activities of daily life (p = 0.01), and a reduction in use of health care resources (p < 0.0001). There was a trend toward decreased use of iron supplements (11 to 4 patients) and transfusions (4 to 0 patients). Two patients (9%) developed rectal ulcers after treatment.

CONCLUSIONS:

KTP laser photocoagulation is a safe and effective therapy for bleeding from chronic radiation proctopathy that improves activities of daily living and reduces use of health care resources.

• Authors: J G Taylor, J A Disario, D J Bjorkman
• Journal: Gastrointestinal endoscopy (Gastrointest Endosc) Vol. 52 Issue 3 Pg. 353-7 (Sep 2000) ISSN: 0016-5107 [Print] United States
• PMID: 10968849 (Publication Type: Comparative Study, Journal Article)

Topics

• Aged
• Aged, 80 and over
• Chronic Disease
• Female
• Gastrointestinal Hemorrhage (etiology, surgery)
• Humans
• Laser Coagulation (methods)
• Male
• Proctitis (etiology, surgery)
• Proctoscopy
• Prognosis
• Prostatic Neoplasms (radiotherapy)
• Radiation Injuries (complications, surgery)
• Retrospective Studies
• Secondary Prevention
• Uterine Neoplasms (radiotherapy)