Argon Plasma Photocoagulation: A Better Alternative for Preventing Chronic Ulcer and Bleeding in Solitary Rectal Ulcer Syndrome? A Scoping Review

Abstract Purpose Solitary Rectal Ulcer Syndrome (SRUS), known as "three-legged illness," involves single or multiple ulcers or hyperemic mucosa sans ulcers. With a complex, poorly understood etiology, treatment aims to address pathogenic processes. Argon Plasma Photocoagulation (APC), a novel approach for SRUS, offers potential advantages. APC is a thermal coagulation therapy that is used to halt bleeding and treat damaged tissue. This review highlights SRUS and APC efficacy vs. traditional therapy in reducing chronic ulcers and bleeding. Method The articles considered were obtained by performing a literature search in the PubMed, Cochrane, and Google Scholar databases, and 32 relevant articles were considered and included in the study. Results Conventional therapies include behavioral therapy, sucralfate enemas, bulk laxatives, high-fiber supplements, and corticosteroid therapy, with rectopexy being a viable surgical option. The literature shows a relatively higher rate of ulcer recurrence and reduced ulcer healing with conservative therapy alone. Argon plasma photocoagulation proved to demonstrate better postoperative ulcer healing, control of bleeding, and lower recurrence rates. The studies found no instances of postoperative complications like intestinal perforation, fistula formation, or infection. It is a better alternative to conventional treatments. Furthermore, APC showed higher efficacy when combined with conventional therapy in terms of treatment for SRUS. Conclusion Argon plasma photocoagulation has shown better postoperative ulcer healing, control of bleeding, and lower recurrence rates. Furthermore, APC showed higher efficacy when combined with conventional therapy for SRUS. Long-term prospective studies and further robust statistical support comparing APC to conventional therapies for SRUS would help us determine a treatment modality of choice with more certainty for SRUS.