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The protective role of antiplatelet treatment against ulcer formation due to argon plasma coagulation in patients treated for chronic radiation proctitis
Author(s) -
ChruscielewskaKiliszek M. R.,
Rupinski M.,
Kraszewska E.,
Pachlewski J.,
Regula J.
Publication year - 2014
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12465
Subject(s) - medicine , argon plasma coagulation , concomitant , asymptomatic , gastroenterology , radiation proctitis , proctitis , radiation therapy , surgery , cancer , prostate cancer , disease , endoscopy , ulcerative colitis
Aim Following treatment with argon plasma coagulation ( APC ), rectal ulceration is seen in approximately 50% of patients with haemorrhagic chronic radiation proctitis ( CRP ). This study aimed to assess the frequency of rectal ulcers (defined as a mucosal defect of 3 mm or more in diameter) in relation to the use of antiplatelet treatment for concomitant cardiovascular disease. Method Sixty‐two patients with CRP were included in this retrospective study. Patients underwent pelvic irradiation due to prostate cancer ( n = 28), cervical cancer ( n = 16), endometrial cancer ( n = 17) or rectal cancer ( n = 1). APC was performed in all patients. Control endoscopies were performed at 8 and 16 weeks after enrolment. Results Rectal ulcers were observed after APC in 35 (56%) patients. They were symptomatic in 5 and asymptomatic in 30. The 20 (32%) patients who were on antiplatelet therapy had a significantly lower risk of ulceration after APC ( OR = 0.21; 95% CI 0.049–0.91; P = 0.019). The number of symptomatic ulcers (5% vs 10%; P = 1.0) and asymptomatic ulcers alone (30% vs 58%; P = 0.06) was also lower in patients respectively taking and not taking antiplatelet therapy, but these differences did not reach statistical significance. Conclusion Argon plasma coagulation‐related ulceration in patients treated for CRP is less common when concomitant antiplatelet treatment is administered. This preliminary finding suggests that antiplatelet therapy may benefit patients treated with APC for CRP .