Argon Plasma Coagulation Research Articles

Place of Plasma Argon Coagulation in the Treatment of Vascular Abnormalities of the Digestive Tract in Adults

AbstractThe aim of our study is to evaluate the value of Argon Plasma Coagulation in the treatment of gastrointestinal vascular abnormalities. Patients and methods This is a descriptive and analytical retrospective study, from January 2009 to September 2020. 198 patients who have benefited from treatment with Argon Plasma Coagulation for vascular anomalies of the digestive tract divided into 2 groups:-Group A: Patients with radial rectitis lesions (n = 107).-Group B: Patients with lesions of digestive angiodysplasia (n = 91). Results The mean age of our patients was 64.95 ± 9.88 years [43 - 83] in group A, while in group B the mean age was 65.19 ± 14.29 years [40 - 91] with a clear male predominance in 72.5%. The majority of patients in group A were followed for prostate cancer in 33,8%, and 26.3% of patients in group B had chronic renal failure, followed by stomach cancer in 15.8%, and esophageal cancer in 10.5%. Clinical symptomatology was dominated by rectories in 40.2% in group A versus 46.8% in group B. Rectal involvement was dominated in group A in 98.1%, whereas in group B the lesions were mainly located in the stomach in 60.5%. The endoscopic evolution was favorable in all our patients with a clear improvement of rectal lesions and digestive angiodysplasia lesions. The total complication rate in our series was nil. Conclusion Plasma Argon coagulation is a very effective method in the endoscopic treatment of digestive haemorrhages with good tolerability and a low complication rate.

Prospective Meta-analysis of Weight Loss Regained and Success Rate of Argon Plasma Coagulation to Suture and Surgery Procedures Post-bariatric Surgery: Status of the Art of Endoscopic Treatment.

This study performed a meta-analysis to compare the safety and efficacy of argon plasma coagulation (APC) concerning suture (SUT) and surgery (SUR). The One-Way tests were applied, with p <0.05 significant. The value of R2 was analyzed (heterogeneity), and the risk of bias of articles was evaluated. A total of 34 studies were found, eight about APC, twenty about SUT, and six about SUR. For the percentage of Weight Loss Regained (%WLR), the means for APC, SUT, and SUR were 19.39 ± 10.94, 26.06 ± 16.71, and 17.05 ± 9.85, and for success rate (%SR), the means were 89.75 ± 16.75, 86.80 ± 11.44, and 76.00 ± 21.57, respectively with p >0.05, with R2 ≥ 50%. The APC proved to be efficient and safe like the other techniques.

COLD SNARE POLYPECTOMY: A SAFE PROCEDURE FOR REMOVING SMALL NON-PEDUNCULATED COLORECTAL LESIONS.

Polypectomy is an important treatment option for preventing colorectal cancer. Incomplete polyp resection (IPR) is re-cognized as a risk factor for interval cancer. The primary objective was to evaluate the complete polyp resection (CPR) rate for cold snare polypectomy (CSP) in small non-pedunculated polyps and, secondarily, specimen retrieval and complication rates. We prospectively evaluated 479 polyps <10 mm removed by CSP in 276 patients by an inexperienced endoscopist. A total of 476 polyps (99.4%) were resected en bloc. A negative margin (classified as CPR) was observed in 435 polyps (90.8%). An unclear or positive margin (classified as IPR) was observed in 43 cases (9.0%) and 1 case (0.2%), respectively, for an overall IPR rate of 9.2% (44/479). The IPR rate was 12.2% in the first half of cases and 5.9% in the second half (P=0.02). Dividing into tertiles, the IPR rate was 15.0% in the first tertile, 6.9% in the second tertile, and 5.7% in the third tertile (P=0.01). Dividing into quartiles, the IPR rate was 15.8% in the first quartile and 5.9% in the fourth quartile (P=0.03). The IPR rate was 6.3% for type 0-IIa lesions and 14.1% for type 0-Is lesions (P=0.01). For serrated and adenomatous lesions, the IPR rate was 9.2%. Specimen retrieval failed in 3.6% of cases. Immediate bleeding (>30 s) occurred in 1 case (0.2%), treated with argon plasma coagulation. No delayed bleeding or perforation occurred. CSP is a safe technique that provides good results for the resection of small non-pedunculated polyps, with a short learning curve.

The effect of argon plasma coagulation on surgical suture material

Introduction. In modern surgery, there are many types of different energy used to achieve hemostasis; one of them is the energy of argon plasma coagulation. However, the impact of energy affects not only the bleeding site; it also affects the stitches lying nearby the source of bleeding. The instructions for the use of a suture material or a coagulation tool do not describe the changes that may occur when they interact. A review of the literature found a small number of publications devoted to changes in the physical properties of suture material when exposed to it. This information is not sufficient to predict the effects of argon plasma coagulation energy on the suture material and, as a result, on wound healing or the quality of the postoperative scar.The objective was to determine changes in the biodestructive properties of synthetic absorbable suture materials with argon plasma coagulation in an in vivo experiment.Methods and materials. In the experimental study, the results of biodegradation of monofilament and polyfilament sutures after exposure to argon plasma coagulation energy were analyzed in comparison with control samples in the body of laboratory mice.Results. It can be unequivocally stated that the effect of argon plasma coagulation energy has an effect on the rate of biodegradation of both monofilament and polyfilament synthetic filaments implanted in muscle tissue.Conclusions. Suture material exposed to argon plasma coagulation may not meet the terms of partial or full biodegradation stated by the manufacturer, which may affect the quality of scar formation.

Snare Tip Soft Coagulation vs Argon Plasma Coagulation vs No Margin Treatment After Large Nonpedunculated Colorectal Polyp Resection: a Randomized Trial

Background and AimsThermal treatment of the defect margin after endoscopic mucosal resection (EMR) of large non-pedunculated colorectal lesions reduces the recurrence rate. Both snare tip soft coagulation (STSC) and argon plasma coagulation (APC) have been used for thermal margin treatment, but there are few data directly comparing STSC to APC for this indication. MethodsWe performed a randomized 3 arm trial in 9 U.S. centers comparing STSC to APC to no margin treatment (control) of defects after EMR of colorectal non-pedunculated lesions ≥ 15 mm. The primary endpoint was the presence of residual lesion at first follow-up. ResultsThere were 384 patients and 414 lesions randomized, and 308 patients (80.2%) with 328 lesions completed ≥ 1 follow-up. The proportion of lesions with residual polyp at first follow-up was 4.6% with STSC, 9.3% with APC and 21.4% with controls (no margin treatment). The odds of residual polyp at first follow-up were lower for STSC and APC when compared to control, p=0.001 and p=0.01, respectively. The difference in odds was not significant between STSC and APC. STSC took less time to apply than APC (median 3.35 vs 4.08 minutes; p=0.019). Adverse event rates were low, with no difference between arms. ConclusionsIn a randomized trial STSC and APC were each superior to no thermal margin treatment after EMR. STSC was faster to apply than APC. Because STSC also results in lower cost and plastic waste than APC (APC requires an additional device ), our study supports STSC as the preferred thermal margin treatment after colorectal EMR. (Clinicaltrials.gov, Number NCT03654209)

Transoral outlet reduction: Outcomes of endoscopic Roux-en-Y gastric bypass revision in 284 patients at a community practice.

Transoral outlet reduction (TORe) is a minimally invasive endoscopic revision of Roux-en-Y gastric bypass (RYGB) for weight recurrence; however, little has been published on its clinical implementation in the community setting. To characterize the safety and efficacy of TORe in the community setting for adults with weight recurrence after RYGB. This is a retrospective cohort study of argon plasma coagulation and purse-string suturing for gastric outlet reduction in consecutive adults with weight recurrence after RYGB at a single community center from September 2020 to September 2022. Patients were provided longitudinal nutritional support via virtual visits. The primary outcome was total body weight loss (TBWL) at twelve months from TORe. Secondary outcomes included TBWL at three months and six months; excess weight loss (EWL) at three, six, and twelve months; twelve-month TBWL by obesity class; predictors of twelve-month TBWL; rates of post-TORe stenosis; and serious adverse events (SAE). Outcomes were reported with descriptive statistics. Two hundred eighty-four adults (91.9% female, age 51.3 years, body mass index 39.3 kg/m2) underwent TORe an average of 13.3 years after RYGB. Median pre- and post-TORe outlet diameter was 35 mm and 8 mm, respectively. TBWL was 11.7% ± 4.6% at three months, 14.3% ± 6.3% at six months, and 17.3% ± 7.9% at twelve months. EWL was 38.4% ± 28.2% at three months, 46.5% ± 35.4% at six months, and 53.5% ± 39.2% at twelve months. The number of follow-up visits attended was the strongest predictor of TBWL at twelve months (R2 = 0.0139, P = 0.0005). Outlet stenosis occurred in 11 patients (3.9%) and was successfully managed with endoscopic dilation. There was one instance of post-procedural nausea requiring overnight observation (SAE rate 0.4%). When performed by an experienced endoscopist and combined with longitudinal nutritional support, purse-string TORe is safe and effective in the community setting for adults with weight recurrence after RYGB.

THE USE OF ARGON PLASMA COAGULATION IN ENDOSCOPY

Relevance: Argon plasma coagulation (APC) is a minimally invasive, non-contact electrosurgery method. This procedure is performed in the following conditions: bleeding in hollow organs, including ulceration after radiation therapy, Barrett’s esophagus, with the germination of a malignant tumor through a stent, benign neoplasms, precancerous conditions, some malignant tumors at the earliest stages. In this article, the authors present the first and successful experience of the use of APC in Kazakhstan during endoscopic interventions in patients with various pathologies.&#x0D; The aim of the study was to evaluate the effectiveness of the introduction of APC as an endoscopic treatment in patients with precancerous pathology and complications of surgical treatment in oncological patients.&#x0D; Methods: A retrospective analysis of the use and effectiveness of AIC was carried out in 15 patients with various pathologies who were on inpatient treatment at the National Research Oncology Center (NROC, Astana, Kazakhstan) during 2022.&#x0D; Results: Barrett’s esophageal APC was successfully performed in the NROC hospital in 6 patients, no signs of intestinal-type metaplasia of the esophageal epithelium were detected in the biopsy material. Two patients with post-radiation hemorrhagic proctitis underwent coagulation in Pulse 15Wt mode and argon flow of 0.4-1.0 L/min. A patient with the GAVE syndrome with hemorrhages underwent 2 sessions of APC in 35Wt mode with a gas flow of 0.8 L/min. In 3 patients with fistulas of the suture of the main bronchus, coagulation was performed after pulmonectomy and closure of the fistula was observed for 1 week. Two patients with esophagoenteroanastomosis failure underwent 2 sessions of APC using 40-watt argon with an interval of 5 days. After anterior rectal resection, the patient had a failure of anastomosis with a multi-chamber cavity and the presence of purulent contents. 4 courses of APC were conducted with an interval of 2 weeks, after the APC, the mouth of the main chamber narrowed, the discharge of pus stopped, as a result, there was a blind pocket up to 2.0 cm without additional chambers and signs of inflammation.&#x0D; Conclusion: The presented article describes the results of the introduction of APC as an endoscopic method of treating patients with various pathologies in an oncological clinic, and based on these results, APC can be recommended for widespread implementation throughout Kazakhstan.

Methods of endoscopic treatment of chronic radiation proctitis

Aim. To compare the clinical effectiveness of argon plasma coagulation (APC) and radiofrequency ablation (RFA) for the treatment of patients with chronic radiation proctitis (CRP) complicated by recurrent rectal bleeding.Methods. A prospective, randomized, single-center study conducted in the State Medical University of the Loginov Moscow State Medical Scientifi Centre. The study included 73 patients with 1—2 degrees of CLP on the RTOG/EORTC scale. The indication for endoscopic treatment was recurrent rectal bleeding. Endoscopic treatment was performed: APC (36 patients) and RF (37 patients), depending on randomization.Results. In 44 patients (60.2 %), of which 18 (50 %) patients in the APC group and 26 (70.2 %) patients in the RF group, a complete regression of the disease was revealed. Telangiectasia was detected in 18 patients (50 %) in the APC group and in 11 patients (29.7 %) in the RF group, which were a continuing source of bleeding. After regression of inflmmatory changes, the patients underwent the second stage of surgery corresponding to the randomization group. After the second stage of surgery in the APC group in 17 patients (94.4 %) and in the RF group in 11 patients (100 %), a complete regression of the disease was revealed. Postoperative pain syndrome occurs in two groups; however, the RF group experiences higher intensity and longer duration of pain.Conclusion: Radiofrequency ablation and argon plasma coagulation are effective and safe treatments for rectal bleeding in chronic radiation proctitis without erosive or ulcerative lesions.

Efficacy and Safety of Argon Plasma Coagulation for the Ablation of Barrett's Esophagus: A Systemic Review and Meta-Analysis.

Argon plasma coagulation (APC) is an alternate ablative method to radiofrequency ablation for the treatment of Barrett's esophagus (BE), and it is preferred due to its lower cost and widespread availability. The present meta-analysis aimed to analyze the safety and efficacy of APC for the management of BE. A literature search from January 2000 to November 2022 was done for studies analyzing the outcome of APC in BE. The primary outcomes were clearance rate of intestinal metaplasia and adverse events (AE). Pooled event rates were expressed with summative statistics. A total of 38 studies were included in the final analysis. The pooled event rate for clearance rate of intestinal metaplasia with APC in BE was 86.8% (95% confidence interval [CI], 83.5% to 90.2%), with high-power and hybrid APC having a higher rate compared to standard APC. The pooled incidence of AE with APC in BE was 22.5% (95% CI, 15.3% to 29.7%), without any significant difference between the subgroups, with self-limited chest pain being the commonest AE. The incidence of serious AE was only 0.4% (95% CI, 0.0% to 1.0%), while stricture development was seen only in 1.7% (95% CI, 0.9% to 2.6%) of cases. The pooled recurrence rate of BE was 16.1% (95% CI, 10.7% to 21.6%), with a significantly lower recurrence with high-power APC than standard APC. High-power and hybrid APC seem to have an advantage over standard APC in terms of clearance rate and recurrence rate. Further studies are required to compare the efficacy and safety of hybrid APC with standard APC and radiofrequency ablation.

Rescue band ligation for a symptomatic duodenal angioectasia at a challenging location involving ancillary lesion marking by argon plasma coagulation

Rescue band ligation for a symptomatic duodenal angioectasia at a challenging location involving ancillary lesion marking by argon plasma coagulation

An expensive gastric piercing: an embedded lumen-apposing metal stent

Video 1Narration of case and demonstration of the endoscopic management of an embedded stent with stent-in-stent technique to induce pressure necrosis, followed by a combination of needle-knife electroincision, argon plasma coagulation, stent intubation and transection with the gastroscope shaft, and cold and hot snare resection.

Endoscopic Manifestations and Clinical Characteristics of Localized Gastric Light-Chain Amyloidosis.

To determine the endoscopic and clinical features of localized gastric amyloid light-chain (AL) amyloidosis, we retrospectively examined the characteristics of nine patients (eight men and one woman) encountered by the hospitals in our network. Lesions were predominantly flat and depressed with surface vascular dilatation (n=5); others were characterized by subepithelial lesions (n=2), mucosal color change (n=1), and a mass-like morphology with swollen mucosal folds (n=1). Colonoscopy (n=7), video capsule enteroscopy (n=2), serum (n=5) and urine immunoelectrophoresis (n=4), and bone marrow examination (n=3) were performed to exclude involvement of organs other than the stomach. As treatment for gastric lesions of AL amyloidosis, one patient each underwent endoscopic submucosal dissection (n=1) and argon plasma coagulation (n=1), while the remaining seven patients underwent no specific treatment. During a mean follow-up of 4.2 years, one patient died 3.2 years after diagnosis, but the cause of death, which occurred in another hospital, was unknown. The remaining eight patients were alive at the last visit. In conclusion, although localized gastric AL amyloidosis can show various macroscopic features on esophagogastroduodenoscopy, flat, depressed lesions with vascular dilatation on the surface are predominant.

S3033 Gastric Perforation Due to Explosion Induced by Argon Plasma Coagulation

S3033 Gastric Perforation Due to Explosion Induced by Argon Plasma Coagulation

S797 Factors Associated With Single vs Multiple Argon Plasma Coagulation Treatments for Gastric Antral Vascular Ectasia: A Nationwide Study

S797 Factors Associated With Single vs Multiple Argon Plasma Coagulation Treatments for Gastric Antral Vascular Ectasia: A Nationwide Study

S607 Efficacy and Safety of Argon Plasma Coagulation for the Ablation of Barrett’s Esophagus – A Systemic Review and Meta-Analysis

S607 Efficacy and Safety of Argon Plasma Coagulation for the Ablation of Barrett’s Esophagus – A Systemic Review and Meta-Analysis

Clinical Outcomes with Triple Tandem Brachytherapy for Medically Inoperable Endometrial Cancer in a Predominantly Black Patient Population

Radiation outcomes for Black patients with medically inoperable endometrial cancer (MIEC) is limited, despite this demographic comprising a higher proportion of the MIEC patient population. We report clinical outcomes and toxicities using triple tandem brachytherapy (TTB) with or without external beam radiation therapy (EBRT) for MIEC in predominantly Black patients. An IRB approved retrospective review was performed of all MIEC patients treated definitively with TTB ± EBRT from 2014-2021 at a single institution. Patients were divided based on stage. Group 1 = FIGO stage 1A/1B and Group 2 = FIGO stage 2-4B. Patients with cervical involvement were treated with TTB + ovoids. The Kaplan-Meier estimates were generated to estimate overall survival (OS) and local failure-free survival (LFFS). Local control (LC) was evaluated clinically. Acute and late toxicities were evaluated. Planning parameters for target volume(s) and OARs (organs at risk) were per ABS guidelines. Statistics reported are median values and ranges. Of 30 patients, 93.3% received TTB + EBRT. Mean age at diagnosis was 65.3 years (40.5-88.7 years). 70% of patients were Black. Median prescribed doses were 45 Gy (range: 21-50.4 Gy) for EBRT and 22.25 Gy (range: 16.5-49.1 Gy) for brachytherapy. Median BMI was 48.1 (27.8- 69) and Charlson Comorbidity Index was 4 (1-11). Patient stages were FIGO 1A/B (n = 19), 2 (n = 1), 3 (n = 1), 3b (n = 1), 3C1 (n = 3), 3C2 (n = 2), and 4B (n = 2) due to inguinal lymphadenopathy. 90% had endometrioid histology while 6.7% and 3.3% had clear cell and serous carcinoma, respectively. Median follow up was 32.1 months (1.7-93.6). Median OS for Group 1 was 50.9 months and 43.5 months for Group 2, while 1-/4-year OS was 84.2%/54.4% and 90.9%/17.5% for Group 1 and 2, respectively (p = 0.616). 53.3% of patients died of non-EC causes. The 1-/4-year LFFS was 100%/93.3% for Group 1 and 90%/70.5% for Group 2 (p = 0.113). Four patients (13.3%) developed recurrence (stage 1A/B, 2, 3C1, and 4B), but only 1 died of disease (Stage 2 with clear cell histology). After EBRT but pre-TTB, 50% (n = 15) and 16.6% (n = 5) had acute grade 2 gastrointestinal (GI) and genitourinary (GU) toxicities, respectively. After TTB treatment, 2 more patients developed acute grade 2 GU toxicity. Late toxicities were Grade 2: GU (n = 1) and GI (n = 1) and Grade 4 GI bleed (n = 1) treated with argon plasma coagulation. TTB ± EBRT for MIEC in predominantly Black patients was associated with excellent LFFS and acceptable toxicity rates, especially in early-stage MIEC with endometrioid histology. Furthermore, even in patients at high risk of death from other causes, LC may help preserve quality of life. Additional studies are needed to evaluate and optimize outcomes for Black patients with MIEC.

Comparing efficacy and factors of postoperative bleeding in endoscopic mucosal resection vs coagulation for intestinal polyps.

This study aimed to assess the effectiveness of Endoscopic Mucosal Resection (EMR) and Argon Plasma Coagulation (APC) as therapeutic approaches for intestinal polyps in patients, and to examine the factors associated with postoperative bleeding. This study included 132 patients diagnosed with colorectal polyps (188 polyps) who underwent endoscopic surgery at our hospital between January 2022 and December 2022. Based on the surgical method employed, the patients were divided into 2 groups: EMR (68 cases, 97 polyps) and APC (64 cases, 91 polyps). Comparative analyses were conducted to assess the clinical efficacy, surgery-related indicators, and quality of life the 2 groups. Furthermore, an investigation was carried out to identify the factors associated with postoperative bleeding. The analysis revealed no statistically significant difference in the cure rate of flat and superficial raised polyps between the EMR group and the APC (P > .05). However, it was found that the EMR group exhibited a significantly higher cure rate for subpedunculated and raised-pedunculated polyps compared to the APC group (P < .05). The results of logistics analysis showed that patients with hypertension (OR = 2.876, 95% CI: 1.119-7.393), patients with diabetes (OR = 5.278, 95% CI: 1.388-20.064), patients with hyperlipidemia (OR = 2.594, 95% CI: 1.054-6.380), the polyps of right hemicolon (OR = 2.743, 95% CI: 1.003-7.504), rectal polyps (OR = 5.143, 95% CI: 1.728-7.504), pedunculated polyps (OR = 4.758, 95% CI: 1.322-17.129), adenomatous polyps (OR = 3.152, 95% CI: 1.018-9.757) were independent risk factors for postoperative bleeding in patients with colorectal polyps (P < .05). The findings suggest that for subpedunculated and pedunculated-raised polyps, EMR can be a suitable treatment approach. On the other hand, flat and superficial-raised polyps can be effectively managed with either EMR or APC. The presence of hypertension, diabetes, hyperlipidemia, polyps of the right hemicolon, rectal polyps, pedunculated polyps, and adenomatous polyps has been established as independent risk factors for postoperative bleeding in patients with colorectal polyps.

Critical Decision Making: Technical Aspects of Esophageal Ablation

Care for patients with dysplastic Barrett’s esophagus is rooted in endoscopic ablative therapies. Radiofrequency ablation (RFA), cryotherapy and argon plasma coagulation, in conjunction with endoscopic resection techniques and optimized pharmacologic and surgical therapy of reflux can lead to complete eradication when the appropriate ablative technology is used in the appropriate Barrett’s patient. This article reviews the critical decisions and technical considerations necessary to be successful in this aspect of Barrett’s care. Use of a cap device, optimal pre ablation preparation and technical aspects of RFA, cryotherapy and argon plasma coagulation are discussed. A detailed algorithm, that if followed, will greatly improve the opportunity for success is presented.

Study the Efficacy of Argon Plasma Coagulation or Endoscopic Band Ligation versus Their Companion in Management of Gastric Antral Vascular Ectasia in Cirrhotic Patients

Abstract Background Gastric antral vascular ectasia (GAVE) is a rare and often misdiagnosed cause of upper gastrointestinal bleeding accounts for up to 4% of all non-variceal upper gastrointestinal bleedings. Multiple options are available for the treatment of GAVE including endoscopic, surgical and medical therapies. Aim of the Work The aim of this study to evaluate the effect of APC followed by EBL in comparison to APC or EBL alone for the treatment of bleeding GAVE in cirrhotic patients. Patients and Methods We conducted this study on 45 adult cirrhotic patients with overt or occult bleeding from GAVE. Patients were divided into 3 groups: 15 patients in each group. Group I was treated with APC alone, group II was treated with EBL alone and Group III was treated with APC followed by EBL. Results In the current study, no statistically significant difference was detected between both groups regarding the etiology of liver cirrhosis, clinical presentation, laboratory or ultrasound findings with special emphasis on pre-treatment hemoglobin value, hospitalizations. APC alone was found to was found to be less effective in the treatment of GAVE when compared to both techniques (EBL and the combined therapy) which were effective in the treatment of GAVE and GAVE recurrence. EBL alone was found to require less number of treatment sessions but required more number of rubber bands and. Combined therapy (APC followed by EBL) successfully decreased the number of banding sessions and decreased the number of rubber bands required to treat GAVE. Conclusion Combined therapy (APC followed by EBL) and EBL alone are effective methods in the treatment of bleeding GAVE in Egyptian cirrhotic patients. EBL alone requires less number of treatment sessions but may require a big number of applied rubber bands. Combined therapy (APC followed by EBL) successfully decreased the number of banding sessions and decreased the number of rubber bands required to treat GAVE. So, in mild cases when less number of rubber bands seems to be required, it is advisable to start with EBL alone: while in severe cases where a large number of rubber bands seems to be required, it is advisable to use combination therapy of APC and EBL.

Comparative efficacy of oral drugs for chronic radiation proctitis — a systematic review

BackgroundChronic radiation proctitis (CRP) is a long-term complication of pelvic radiotherapy that manifests as rectal bleeding, diarrhoea, fistula formation and obstruction. Treatments such as endoscopic argon plasma coagulation, hyperbaric oxygen therapy and rectal topical formalin have imposed a significant medical burden on CRP patients. In contrast, oral therapies offer a more accessible and acceptable option for managing CRP. Here, we conducted a systematic review of the efficacy of oral treatments for CRP to assess their potential as an effective and convenient treatment option for this condition.MethodsWe searched the Cochrane Central Register of Controlled Trials, PubMed, Web of Science, China National Knowledge Infrastructure and Chinese VIP in February 2021. We included post-radiotherapy participants with CRP that compared oral medicine alone or in combination with other treatments versus control treatments. The primary outcomes were bleeding, diarrhoea and symptom score. Heterogeneity between studies was checked using Cochrane Q test statistics and I2 test statistics. The Cochrane risk-of-bias tool was used to assess the quality of the included studies.ResultsWe included 10 randomised controlled trials (RCTs) and 1 retrospective study with 898 participants. Three placebo-controlled trials evaluated the effects of oral sucralfate on CRP, with meta-analysis showing no significant different with placebo arm. Four trials on TCM demonstrated significant improvement of symptoms, especially for the 3 trials on oral TCM drinks. Retinyl palmitate and high-fibre diet were found to reduce rectal bleeding. The combination of oral pentoxifylline and tocopherol did not significantly change the process of CRP.ConclusionsOur study implies that oral TCM drinks, retinyl palmitate and a high-fiber diet showed significant improvement in CRP symptoms, but not with the combination of oral pentoxifylline and tocopherol. Further multicentre, larger-scale RCTs are needed to confirm the efficacy and safety of these treatments and optimize treatment strategies, ultimately improving the quality of life for patients with CRP.