Background:
argon plasma coagulation (APC) is the current endoscopic
treatment of choice for
patients who develop chronic
radiation proctopathy. The aim of this study was to identify
risk factors associated with
treatment failure.
Methods:
one hundred and ninety-nine
patients treated with
argon plasma coagulation in a single center were retrospectively analyzed.
Results:
twenty-four (12.06 %)
patients were classified as APC
treatment failures. Requirement of
red blood cells transfusion and/or
hemoglobin < 7 g/dl (OR 12.19, 95 % CI 2.78-53.45, p < 0.001) and severe
bleeding frequency (OR 2.76, 95 % CI 1.13-6.72, p = 0.03) at
diagnosis and prior to endoscopic
therapy were associated with
argon plasma coagulation treatment failure. Nineteen
patients of the successful
therapy group developed
bleeding recurrence; no
risk factors were associated with a shorter
recurrence-free
time. More than four APC sessions were associated to a higher
risk of surgical intervention for
bleeding control (OR 87.00, 95 % CI 10.23-740.18, p < 0.001).
Conclusion:
requirement of
red blood cells transfusion and/or
hemoglobin < 7 g/dl and a severe
bleeding frequency (more than five days per week) were identified as the most important
risk factors for
treatment failure in
patients with chronic
radiation proctopathy. (AU)