Analysis of therapeutic results of argon plasma coagulation for chronic hemorrhagic radiation proctitis
Diego Gianetti Bahamonde- Danny Oksenberg Reisberg
- Alejandro Readi Vallejos
- Marcelo Rodríguez González
- Gonzalo Campaña Villegas
Published 2026-10-30
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Abstract
Introduction: Hemorrhagic chronic radiation proctitis (CRP) is a complication of pelvic radiotherapy. Argon plasma coagulation (APC) is a recommended treatment, but local evidence is lacking. The objective was to evaluate the clinical, hematological, and endoscopic therapeutic response, alongside recurrence and safety of APC.
Methodology: Retrospective cohort study (2015-2025) in 33 patients with CRP treated with APC. Clinical response (absence of or mild bleeding), hemoglobin changes, Saunders endoscopic score, number of sessions, complications (Clavien-Dindo), and recurrence were evaluated.
Results: Favorable clinical response was achieved in 87.9% of cases. In paired evaluation, hemoglobin increased from 10.2 to 11.7 g/dL (p = 0.0004) and the endoscopic score decreased from 4 (3–4) to 2 (1–3). The median number of sessions was 1.0. Morbidity was 12.1% (minor complications). There was one death due to refractory hemorrhage subsequently treated with formalin and surgery. Recurrence was 30.3% at a median follow-up of 8 months.
Discussion: This is the first national report focused on APC for CRP. The efficacy, low number of sessions, and observed safety align with international literature. The recurrence rate reflects the chronic nature of radiation-induced rectal damage.
Conclusion: In the context of this retrospective cohort, APC presents as an alternative that suggests effectiveness and safety for bleeding control in patients with chronic radiation proctitis, providing local evidence that supports its consideration in clinical practice.