Treatment of hemorrhagic radiation-induced proctopathy with a 4% formalin application under perianal anesthetic infiltration

AIM:To evaluate the results of hemorrhagic radiation proctopathy treatment with a 4% formalin application.METHODS:A prospective study was performed.Over a three-year period,38 patients underwent 4% formalin application under perianal anesthetic infiltration for hemorrhagic radiation proctopathy.All patients included in the study were irradiated for prostate cancer.The patients ranged in age from 56-77 years(average 70 ± 5 years).All of the patients were referred for formalin therapy after noninvasive management had failed.Twenty-four(63.2%)patients underwent a single application,10(26.3%)patients underwent 2 applications,and 4(10.5%)patients underwent 3 applications.RESULTS:Two to 36 mo(average 12 ± 3 mo)following treatment,34 patients were interviewed(four were lost to follow-up).Twenty(58.8%)subjects reported complete cure,8(23.5%)subjects reported significant improvement,and 6(17.7%)subjects reported no change.One patient(who underwent a colostomy at a regional hospital with no specialized services available for previous bleeding episodes from radiation proctopathy)was cured,and the colostomy was closed.One patient(2.6%)developed rectal mucosal damage after the second application.CONCLUSION:A 4-min application of 4% formalin for hemorrhagic radiation-induced proctopathy under perianal anesthetic infiltration in patients who have received external radial radiation therapy for prostate cancer is simple,reasonably safe,inexpensive,generally well tolerated,and effective.

International guideline on natural orifice specimen extraction surgery(NOSES)for colorectal cancer(2023 version)

Purpose In recent years,natural orifice specimen extraction surgery(NOSES)has gained widespread attention as an alternative approach.Although the safety and feasibility of NOSES have been well documented,many questions remain open for discussion.The aim of this guideline is to provide more evidence for the promotion of NOSES.Methods This guideline has been prepared by the CACA Committee of Colorectal Cancer Society and the International NOSES Alliance,based on the latest evidence.Results The guideline on NOSES for colorectal cancer include the definition,classification,technology requirement,indications,technical difficulties and clinical research.Conclusion The guideline provides a full introduction of the theoretical and technical aspects of NOSES for colorectal cancer which will beneficial to development of NOSES.