Trial of Endoscopy Bipolar and Argon of Chronic Rectal Bleeding From Radiation Telangiectasias
Condition: Radiation Injuries; Telangiectasis
MeSH terms: Telangiectasis; Radiation Injuries
Study type: Interventional
Phase: Phase 4

Summary: 
      Aim:

      To compare the efficacy, safety and number of sessions of bipolar eletrocoagulation (BEC) and
      argon plasma coagulation (APC) in the management of the bleeding telangiectasias from chronic
      radiation coloproctopathy (CRCP).

      Methods:

      Thirty patients with active bleeding from telangiectasias were enrolled in two groups (15 BEC
      and 15 APC) and classified according of Saunders score. BEC settings were 50 W and APC
      settings were 40 W and 1.0 l/min. Colonoscopy was the first exam to rule out synchronous
      lesions and follow-up was performed with sigmoidoscopies. Clinical cure was defined as
      cessation of bleeding and endoscopic cure was determined by absence of telangiectasias.
      Failure was defined whenever more than 7 sessions or other therapy was necessary.
    

Detailed description: 
      Thirty patients with active and chronic hematochezia from radiation telangiectasias were
      randomized in two groups :

        -  fifteen patients in group 1- bipolar eletrocoagulation (BE) and

        -  fifteen in group 2 - argon plasma coagulation(APC). For inclusion in the study, all
           patients were required to have active (at least one episode last week) and chronic
           (persist or appear 6 months after the conclusion of radiotherapy) rectal bleeding.
           Between May 2005 and April 2008, patients were treated and followed at the Endoscopy
           Unit in the São Paulo Hospital (UNIFESP).
    

Intervention name(s): Bipolar eletrocoagulation; Argon Plasma Coagulation
Intervention type(s): Device; Device
Intervention description(s): Bipolar Eletrocoagulation was performed with a high-frequency electrosurgical generator (ERBE® ICC 200 Eletromedizin, Tubingen, Germany), using Gold probe (Wilson- Cook®) with 7 Fr diameter and 300 cm length. The power setting was 50 W. Coagulation of each telangiectasia was achieved with the probes by applying light pressure directly on the telangiectasia.; Argon plasma coagulation was delivered using a "spray-painting" technique, with short applications at 40 W power with a gas flow of 1.0l per minute. APC equipment was an argon delivery unit (ERBE® ICC 300) coupled a high frequency surgery unit (ERBE® ICC 200). Only the end-firing probe with 2.3 mm and 220 cm length was used. The probe was purged with argon, tested and passed though the endoscope until it extends approximately 1 cm from the tip. The probe was hold just above the mucosal surface and the contact was avoided. During the procedure periodic suction was made to prevent over-distention with gas and consequently patient discomfort.
Other intervention name(s): - bipolar probe; - bipolar electrocoagulation; Argon Laser; Argonio
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Radiation Injuries; Telangiectasis; Bipolar Eletrocoagulation; Argon Plasma Coagulation