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Fulltext Formalin dab for radiation proctitis--an effective day care procedure

Ramesh G, Khamizar W

Med J Malaysia, 2005 Jun;60(2):201-3.
PMID: 16114161

The use of high voltage radiotheraphy in pelvi malignancies has led to a common complication which is radiation . proctitis. Treatment with rectal formalin is simple and effective and can be done as a day care procedure. The use of formalin dab was assessed as a day care procedure in our surgical unit in which ten patients were prospectively evaluated. Outcome of these patients was encouraging.

Matched MeSH terms: Proctitis/drug therapy*
Formalin dab for haemorrhagic radiation proctitis

Ismail MA, Qureshi MA

Ann R Coll Surg Engl, 2002 Jul;84(4):263-4.
PMID: 12215030

BACKGROUND: Haemorrhagic radiation proctitis frequently presents as a problem in management. We analysed the technique of formalin dab in its management.
PATIENTS AND METHODS: Twenty patients presenting with haemorrhagic radiation proctitis and treated with formalin dab were prospectively analysed.
RESULTS: Twelve patients ceased to bleed following one session of formnalin dab. Six patients needed more than one session to effect haemostasis. Two of three patients with torrential bleeding failed to respond to formalin dab and required surgical excision of the rectum.
CONCLUSION: Formalin dab is a simple, effective and safe treatment modality in the management of chronic haemorrhagic radiation proctitis, and hence should be considered as the initial treatment modality for such a condition.

Matched MeSH terms: Proctitis/drug therapy*
Pharmacotherapy for chronic hemorrhagic radiation proctitis

Gul YA, Prasannan S, Jabar FM, Shaker AR, Moissinac K

World J Surg, 2002 Dec;26(12):1499-502.
PMID: 12297939 DOI: 10.1007/s00268-002-6529-8

Endoscopic thermal therapy and formalin are being increasingly recommended for the treatment of chronic hemorrhagic radiation proctitis. It may be too early, however, to discard pharmacologic agents from the management process, especially in medical institutions where specialized equipment is unavailable. We prospectively assessed the effectiveness of medical therapy in 14 consecutive patients with chronic hemorrhagic radiation proctitis from July 1999 to June 2001. All 14 subjects were women (mean age 56 years), 13 of whom had had radiotherapy for cancer of the cervix. The median time to onset of symptoms following irradiation was 16 months. Six patients had a hemoglobin level of < 8 g/dl, and blood transfusion was required in 11 patients. In five patients (36%) initially treated with hydrocortisone enemas prior to referral, this treatment continued; and the remaining nine patients were commenced on sucralfate enemas. Two patients given rectal hydrocortisone continued to bleed and were treated with sucralfate enemas and topical formalin, respectively. Rectal sucralfate suspension effectively procured symptomatic alleviation in all 11 patients. Rectal bleeding recurred in two patients who had been managed exclusively with hydrocortisone and sucralfate enemas, respectively, over a mean follow-up of 6 months. Both patients were managed with topical formalin, which controlled their symptoms. Even though the number of subjects in this study is small, sucralfate enema can be recommended as an effective first-line agent for managing patients with chronic hemorrhagic radiation proctitis. The use of more specialized therapy can therefore be reserved for cases where primary treatment failure occurs with sucralfate therapy.

Matched MeSH terms: Proctitis/drug therapy*

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