Martínez JR, Manrique MA, Pérez VE, Chávez MA

Language: Spanish
References: 30
Page: 148-156
PDF size: 224.72 Kb.

ABSTRACT

Background. The radiation proctitis represents a problematic complication of pelvic radiotherapy, which is present up to 75% of patients to whom pelvic irradiation therapy was applied. Five percent turn into a complicated chronic proctitis due to telangiectasias and hemorrhage. The usefulness of rectal formol (analogous to formalin), endoscopically instilled for bleeding treatment is prospectively evaluated on this research. Methodology. Seven patients (women) with recurrent rectal bleeding, relapsing and secondary to chronic hemorrhagic radiation proctitis and candidates to proctectomy were treated with 2% formol instillation, as a unique endoscopic intrarectal treatment, in 4 aliquots of 20 c.c., each one with about 15 minutes of mucous contact. The patients were evaluated at the beginning, at 7, 14 and 30 days after, by clinical examination, endoscopy and laboratory tests. Results. Practically, rectal mucosa was whole affected in all patient, finding the bigger damage of mucosa on the first 4 cm upon the dentate line, and was extended 12 cm in average (rank from 8 to 14 cm). A mean of one session (rank of 1 to 2) was necessary to get complete relief from rectal bleeding. A hundred percent of patients, during our 8 months follow-up, had good initial response clinically with disappearance of rectal bleeding, one patient require 2 more instillations to report a total improvement of rectal bleeding. All patients keep up their monthly hemoglobin levels and never require a blood transfusion during the follow-up period. Conclusion. Even when the study had a little sample and a short follow-up, the obtained results show that 4% formol (formalin) rectal bleeding endoscopic instillation, represents a promiser and efficacious method for severe hemorrhagic proctitis for radiation treatment, however it is required a bigger sample and more follow-up time to valuate the real impact of the formol on the evolution of the hemorrhagic proctitis due to radiation.

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