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Erschienen in: International Journal of Colorectal Disease 2/2013

01.02.2013 | Original Article

Chronic radiation-induced proctitis: the 4 % formalin application as non-surgical treatment

verfasst von: Daniele Pironi, Alessandra Panarese, Maurizio Vendettuoli, Stefano Pontone, Salvatore Candioli, Annarita Manigrasso, Flaminia De Cristofaro, Angelo Filippini

Erschienen in: International Journal of Colorectal Disease | Ausgabe 2/2013

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Abstract

Purpose

Radiation proctitis is a known complication following radiation therapy for pelvic malignancy. The majority of cases are treated nonsurgically. Rectal instillation of formalin solution has been described as a successful treatment for chronic radiation-induced hemorrhagic proctitis resistant to medical treatment. We present our results in patients undergoing treatment with application of 4 % formalin for radiation-induced injury to the rectum.

Methods

All patients were treated under anesthesia by direct application of 4 % formalin solution to the affected rectal areas. Patient gender, initial malignancy, grade of proctitis, need for blood transfusion, previous therapy, number of applications and response to treatment with formalin, complications, and length of follow-up were reviewed.

Results

A total of 15 patients with a mean age of 68.9 (range, 48–77) years were followed for 31.3 (range, 18–51) months. The mean interval from the conclusion of radiotherapy and the onset of symptoms was 6.9 months. The mean duration of hemorrhagic proctitis before formalin application was 7.9 months. Ten patients had only one formalin application and five patients required a second application because of the persistent bleeding. Thirteen patients (87 %) had complete cessation of bleeding. No complications related to the formalin treatment were observed.

Conclusions

According to a revision of the literature and our experience, despite the small number of patients in our trial, we can state that the application of 4 % formalin solution is an effective, safe, and well-tolerated treatment for chronic radiation-induced hemorrhagic proctitis with minimal discomfort and no severe complications.
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Metadaten
Titel
Chronic radiation-induced proctitis: the 4 % formalin application as non-surgical treatment
verfasst von
Daniele Pironi
Alessandra Panarese
Maurizio Vendettuoli
Stefano Pontone
Salvatore Candioli
Annarita Manigrasso
Flaminia De Cristofaro
Angelo Filippini
Publikationsdatum
01.02.2013
Verlag
Springer-Verlag
Erschienen in
International Journal of Colorectal Disease / Ausgabe 2/2013
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-012-1571-y

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