Infrared Coagulator™: A Useful Tool for Treating Anal Squamous Intraepithelial Lesions

  title={Infrared Coagulator{\texttrademark}: A Useful Tool for Treating Anal Squamous Intraepithelial Lesions},
  author={Stephen E Goldstone and Adam Z Kawalek and Jeff W Huyett},
  journal={Diseases of the Colon \& Rectum},
PURPOSEThe incidence of invasive anal squamous carcinoma in men who have sex with men is rising, particularly in those with human immunodeficiency virus. As in the cervix the high-grade squamous intraepithelial lesion is thought to be an invasive squamous cell carcinoma precursor. Cervical high-grade squamous intraepithelial lesions are treated by removing the squamocolumnar transition zone. This is not possible in the anus, where treatment is often surgical and is accompanied by significant… 
High Resolution Anoscopy in the Planned Staged Treatment of Anal Squamous Intraepithelial Lesions in HIV-Negative Patients
HRA-targeted surgical therapy coupled with surveillance and re-treatment with office-based therapies offered an effective method in controlling anal dysplasia in the immunocompetent patient.
Management of anal squamous intraepithelial lesions.
The treatment option associated with the best outcomes is ablation directed with HRA, which can be performed in the office or in the operating room with minimal morbidity and is effective in patients with both low-volume and high-volume disease.
Treatment of High-Grade Anal Intraepithelial Neoplasia With Infrared Coagulation in a Primary Care Population of HIV-Infected Men and Women
Infrared coagulation is an effective treatment for high-grade anal intraepithelial neoplasia and none had progressed to squamous-cell carcinoma.
Diagnosis and Treatment of Anal Intraepithelial Neoplasia and Condylomata
A critical review of the literature and evidence-based, comparative analysis and discussion of treatment modalities for anal HPV related diseases was undertaken, finding that there is no pharmacologic therapy approved by the Food and Drug Administration for intraanal HPV-related disease.
Current treatment options for management of anal intraepithelial neoplasia
  • S. Weis
  • Medicine
    OncoTargets and therapy
  • 2013
High-resolution anoscopy-directed HGAIN ablation is evolving into a standard approach for initial treatment and then subsequent monitoring of a disease which should be expected to be recurrent.
Infrared Coagulator Ablation of High-Grade Anal Squamous Intraepithelial Lesions in HIV-Negative Males Who Have Sex with Males
Although recurrence was high after the first infrared coagulation, repeated treatment led to resolution of high-grade squamous intraepithelial lesions, and treatment success with infraredCoagulation is significantly superior in HIV-negative patients compared with HIV-positive patients.
Long-term Outcome of Ablation of Anal High-grade Squamous Intraepithelial Lesions: Recurrence and Incidence of Cancer
Patients undergoing ablation of intra-anal high-grade dysplasia have high recurrence, but the probability of developing anal cancer is low, and HIV infection and increased number of high- grade dysplasias increases the risk of recurrence.
Ablative therapies for the treatment of anal high-grade squamous intraepithelial lesions
Recurrence is to be expected following treatment of HSIL, highlighting the need for close long-term follow-up and ablation has been shown to be more effective and better tolerated compared to topical treatments.
Establishing an anal dysplasia clinic for HIV-infected men: initial experience.
Initial experience in assessing the frequency and severity of anal intraepithelial neoplasia (AIN) in a newly formed anal dysplasia clinic in Seattle suggests that the clinic is expanding rapidly, with excellent community and provider support.
Infrared Coagulator Treatment of High-Grade Anal Dysplasia in HIV-Infected Individuals: An AIDS Malignancy Consortium Pilot Study
The IRC is a well-tolerated method of treating discrete anal canal HSILs in HIV-infected patients and a larger study to characterize its efficacy better in the management of HSIL’s in AIDS Malignancy Consortium sites is warranted.


Surgical Treatment of High-Grade Anal Squamous Intraepithelial Lesions: A Prospective Study
Surgical intervention directed by high-resolution anoscopy is safe and eliminates high-grade squamous intraepithelial lesions in human immunodeficiency virus-negative patients.
High prevalence of anal squamous intraepithelial lesions and squamous-cell carcinoma in men who have sex with men as seen in a surgical practice
Men who have sex with men referred for treatment of either condyloma or noncondylomatous benign anorectal disease had a high prevalence of anal high-grade squamous intraepithelial lesions and anal squamous-cell cancer.
Colposcopic appearance of anal squamous intraepithelial lesions
The colposcopic appearance of different grades of anal squamous intraepithelial lesions was similar to those described for the cervix, and incorporation of colposcopy into assessment of anal disease could aid in distinguishing anal LSIL from HSIL.
Prevalence and risk factors for anal squamous intraepithelial lesions in women.
HIV-positive women had a higher risk of abnormal anal cytology than did HIV-negative women with high-risk lifestyle factors and these data provide strong support for anoscopic and histologic assessment and careful follow-up of women with abnormal anal lesions.
Angiogenesis, proliferation, and apoptosis in anal high-grade squamous intraepithelial lesions
PURPOSE: Management of anal high-grade squamous intraepithelial lesions is controversial. Anal and cervical high-grade squamous intraepithelial lesions are similar in that they occur in transitional
Anal squamous intraepithelial lesions: relation to HIV and human papillomavirus infection.
  • J. Palefsky
  • Medicine, Biology
    Journal of acquired immune deficiency syndromes
  • 1999
Cost-effectiveness analyses suggest that anal screening programs may be cost-effective in HIV-positive men, but barriers to implementation of screening include inadequate numbers of clinicians skilled in diagnosis and treatment of HSIL and lack of medical alternatives to surgical excision.
The pathology and molecular biology of anal intraepithelial neoplasia: comparisons with cervical and vulvar intraepithelial carcinoma
It appears that there is an antigen-specific hyporesponsiveness by cytotoxic lymphocytes against HPV peptide sequences or recombinant proteins encoded by oncogenic HPV subtypes in these patients, which is dependent upon the stage of their HIV-associated disease.
Recrudescence of cervical dysplasia among women who are infected with the human immunodeficiency virus: a case-control analysis.
Hysterectomy fared better than standard therapy (50% vs 86%), but recurrences were significant, and higher recurrence rates were seen with CD4 counts <200 cells/mm3.
Prospective study of high grade anal squamous intraepithelial neoplasia in a cohort of homosexual men: influence of HIV infection, immunosuppression, and human papillomavirus infection
The association of HG-AIN with HIV, independent of HPV type, level of HPV detection, and number of positive HPV tests, suggests that this increased risk cannot be entirely explained by an effect of HIV on HPV detection.