Surgical treatment of rectal bleeding in comorbid patients with chronic radiation proctitis

Radiation proctitis is a rare and significant complication of the combined therapy in patients with pelvic cancer. The choice of treatment of chronic radiation proctitis depends on the stage of disease and recurrent rectal bleeding. Comorbidity is cause to complicated proctitis. These clinical cases describe the choice and sequence of surgical interventions in order to achieve successful results in patients with chronic radiation proctitis.

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4483 Argon plasma coagulation is an effective and well tolerated treatment for rectal bleeding due to chronic radiation proctitis.

Gastrointestinal Endoscopy ◽

10.1016/s0016-5107(00)14330-5 ◽

2000 ◽

Vol 51 (4) ◽

pp. AB147 ◽

Cited By ~ 1

Author(s):

Mehdi Kaassis ◽

Frederic Oberti ◽

Pascal Burtin ◽

Jean Boyer

Keyword(s):

Rectal Bleeding ◽

Argon Plasma Coagulation ◽

Argon Plasma ◽

Radiation Proctitis ◽

Plasma Coagulation ◽

Chronic Radiation Proctitis ◽

Chronic Radiation

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Altered Gut Microbiota Associated with Hemorrhage in Chronic Radiation Proctitis

10.21203/rs.3.rs-16229/v1 ◽

2020 ◽

Author(s):

Liangzhe Liu ◽

Bingcheng Chen ◽

Chaoyun Chen ◽

Chen Ding ◽

Nana Xiao ◽

...

Keyword(s):

Gut Microbiota ◽

16S Rrna Gene Sequencing ◽

Radiation Proctitis ◽

Rrna Gene ◽

Chronic Radiation Proctitis ◽

Chronic Radiation ◽

Pelvic Cancer ◽

Metagenomic Study ◽

Rrna Gene Sequencing ◽

And Function

Abstract Background: Pelvic cancer radiotherapy may cause chronic radiation proctitis (CRP) that adversely affects patient’s quality of life. Here, we aimed to characterize the gut microbiota of CRP patients and reveal the association of dysbiosis and hematochezia. A comparative metagenomic study of CRP with and without hematochezia was conducted by 16S rRNA gene sequencing. Results: Different patterns of dysbiosis were observed in CRP patients with and without hematochezia. The abundance of Bacteroides was higher in CRP patients without hematochezia. The Verrucomicrobia phylum was enriched while the compositions of the Enterobacteriales family and the Porphyromonadaceae genus were relatively lower in the microbiota of CRP patients with hematochezia. PICRUSt analysis suggested that the expression of Fe-S protein, Glutathione peroxidase and Glutaredoxin-related protein were increased, indicating an exacerbated inflammation state in hematochezia patients. Conclusions: This study provides new insight to the altered composition and function of gut microbiota in patients with hematochezia, implying the link of CRP symptom and bacterial ecosystem on rectal epithelial layer.

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Conservative therapies for hemorrhagic radiation proctitis: a review

Revista do Hospital das Clínicas ◽

10.1590/s0041-87812003000500008 ◽

2003 ◽

Vol 58 (5) ◽

pp. 284-292 ◽

Cited By ~ 28

Author(s):

Guilherme Cotti ◽

Victor Seid ◽

Sérgio Araujo ◽

Afonso Henrique Silva e Souza Jr. ◽

Desidério Roberto Kiss ◽

...

Keyword(s):

Argon Plasma Coagulation ◽

Argon Plasma ◽

Radiation Proctitis ◽

High Morbidity ◽

Major Drawback ◽

Permanent Colostomy ◽

Chronic Radiation Proctitis ◽

Chronic Radiation ◽

Pelvic Cancer ◽

The Common

Chronic radiation proctitis represents a challenging condition seen with increased frequency due to the common use of radiation for treatment of pelvic cancer. Hemorrhagic radiation proctitis represents the most feared complication of chronic radiation proctitis. There is no consensus for the management of this condition despite the great number of clinical approaches and techniques that have been employed. Rectal resection represents an available option although associated with high morbidity and risk of permanent colostomy. The effectiveness of nonoperative approaches remains far from desirable, and hemorrhagic recurrence represents a major drawback that leads to a need for consecutive therapeutic sessions and combination of techniques. We conducted a critical review of published reports regarding conservative management of hemorrhagic chronic radiation proctitis. Although prospective randomized trials about hemorrhagic radiation proctitis are still lacking, there is enough evidence to conclude that topical formalin therapy and an endoscopic approach delivering an argon plasma coagulation represent available options associated with elevated effectiveness for interruption of rectal bleeding in patients with chronic radiation proctitis.

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Altered Gut Microbiota Associated with Hemorrhage in Chronic Radiation Proctitis

10.21203/rs.3.rs-16229/v2 ◽

2020 ◽

Author(s):

Liangzhe Liu ◽

Chaoyun Chen ◽

Chen Ding ◽

Bingcheng Chen ◽

Jinjun Liang

Keyword(s):

Gut Microbiota ◽

Arachidonic Acid Metabolism ◽

Radiation Proctitis ◽

Mineral Absorption ◽

Chronic Radiation Proctitis ◽

Chronic Radiation ◽

Pelvic Cancer ◽

Significant Difference ◽

Radiation Induced

Abstract Background: Pelvic cancer radiotherapy may cause chronic radiation proctitis (CRP) that adversely affects patient’s quality of life, especially in patients with prolonged hematochezia. However, previous studies of radiation enteropathy mainly focused on acute irradiation hazards, and the detail pathogenesis process and mechanism of prolonged hematochezia associated with radiation-induce toxicity remain unclear. Methods: The 16S DNA of gut microbiota of 32 CRP patients with or without hematochezia were sequenced. The diversities and densities of gut microbiota were analyzed. Findings: Differential patterns of dysbiosis were observed. The abundance of Peptostreptococcaceae, Eubacterium and Allisonella were significantly higher in CRP patients with hematochezia, while the compositions of the Lachnospiraceae, Megasphera, Megamonas and Ruminococcaceae were lower in the microbiota of non-hematochezia patients. Functional prediction suggested significant difference in the expression of mineral absorption and the Arachidonic Acid metabolism proteins between hematochezia and non-hematochezia patients, possibly interdependent on radiation-induced inflammation. Interpretation: This study provides new insight to the function of gut microbiota in hemorrhage symptom of CRP patients. Further study is required to select probiotics and prebiotics to improve intestinal homoeostasis and relief prolonged hematochezia in CRP patients.

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Altered Gut Microbiota Associated With Hemorrhage in Chronic Radiation Proctitis

Frontiers in Oncology ◽

10.3389/fonc.2021.637265 ◽

2021 ◽

Vol 11 ◽

Author(s):

Liangzhe Liu ◽

Chaoyun Chen ◽

Xia Liu ◽

Bingcheng Chen ◽

Chen Ding ◽

...

Keyword(s):

Gut Microbiota ◽

Arachidonic Acid Metabolism ◽

Radiation Proctitis ◽

Mineral Absorption ◽

Chronic Radiation Proctitis ◽

Chronic Radiation ◽

Pelvic Cancer ◽

Significant Difference ◽

Radiation Induced ◽

And Function

Pelvic cancer radiotherapy may cause chronic radiation proctitis (CRP) that adversely affects patient’s quality of life, especially in patients with prolonged hematochezia. However, previous studies of radiation enteropathy mainly focused on acute irradiation hazards, and the detailed pathogenesis process and mechanism of prolonged hematochezia associated with radiation-induced toxicity remain unclear. In this study, we characterized the gut microbiota of 32 female CRP patients with or without hematochezia. Differential patterns of dysbiosis were observed. The abundance of Peptostreptococcaceae, Eubacterium, and Allisonella was significantly higher in CRP patients with hematochezia, while the compositions of the Lachnospiraceae, Megasphera, Megamonas, and Ruminococcaceae were lower in the microbiota of non-hematochezia patients. Functional prediction suggested significant difference in the expression of mineral absorption and the arachidonic acid metabolism proteins between hematochezia and non-hematochezia patients, possibly interdependent on radiation-induced inflammation. This study provides new insight into the altered composition and function of gut microbiota in patients with hematochezia, implying the potential use of probiotics and prebiotics for assessment and treatment of CRP.

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