ASGE guideline on the role of endoscopy for bleeding from chronic radiation proctopathy

Jeffrey K. Lee, Deepak Agrawal, Nirav Thosani, Mohammad Al-Haddad, James L. Buxbaum, Audrey H. Calderwood, Douglas S. Fishman, Larissa L. Fujii-Lau, Laith H. Jamil, Terry L. Jue, Mouen A. Khashab, Joanna K. Law, Mariam Naveed, Bashar J. Qumseya, Mandeep S. Sawhney, Andrew C. Storm, Julie Yang, Sachin B. Wani

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Abstract

Chronic radiation proctopathy is a common sequela of radiation therapy for malignancies in the pelvic region. A variety of medical and endoscopic therapies have been used for the management of bleeding from chronic radiation proctopathy. In this guideline, we reviewed the results of a systematic search of the literature from 1946 to 2017 to formulate clinical questions and recommendations on the role of endoscopy for bleeding from chronic radiation proctopathy. The following endoscopic modalities are discussed in our document: argon plasma coagulation, bipolar electrocoagulation, heater probe, radiofrequency ablation, and cryoablation. Most studies were small observational studies, and the evidence for effectiveness of endoscopic therapy for chronic radiation proctopathy was limited because of a lack of controlled trials and comparative studies. Despite this limitation, our systematic review found that argon plasma coagulation, bipolar electrocoagulation, heater probe, and radiofrequency ablation were effective in the treatment of rectal bleeding from chronic radiation proctopathy.

Original languageEnglish (US)
Pages (from-to)171-182.e1
JournalGastrointestinal endoscopy
Volume90
Issue number2
DOIs
StatePublished - Aug 2019

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Lee, J. K., Agrawal, D., Thosani, N., Al-Haddad, M., Buxbaum, J. L., Calderwood, A. H., Fishman, D. S., Fujii-Lau, L. L., Jamil, L. H., Jue, T. L., Khashab, M. A., Law, J. K., Naveed, M., Qumseya, B. J., Sawhney, M. S., Storm, A. C., Yang, J., & Wani, S. B. (2019). ASGE guideline on the role of endoscopy for bleeding from chronic radiation proctopathy. Gastrointestinal endoscopy, 90(2), 171-182.e1. https://doi.org/10.1016/j.gie.2019.04.234