Greta Taitelbaum

7087 Argon plasma coagulation in endoscopic therapy.

The goal of the study was to review the experience of a single institution in using Argon Plasma Coagulation (APC) to obliterate gastrointestinal vascular and mass lesions. Background: APC is a non-contact electrocoagulation in which current is applied to tissues by means of ionized argon gas.The maximum coagulation depth is 3-4 mm. The absence of adhesion between the coagulation electrode and the tissue as well as symmetric spread of the coagulation through surrounding mucosa provide a theoretical advantage over standard electrocoagulation. Methods: The medical records, endoscopic findings, and complications for all patients treated with APC between April 1997 and October 1999 were reviewed. Results: During this period, APC was performed on 36 patients in 61 sessions. Argon flow was set at 0.4 L/min and electrical power at 55 Watts (mean; range 40-60 Watts).The diameter of the probe was 2.3 mm (manufactured by ERBE Inc, Marietta, GA).Treated lesions were Gasric antral vascular ectasia (GAVE; 14 sessions; 8 patients),AVM (13 sessions; 9 patients), radiation proctitis (16 sessions; 8 patients), radiation enteritis (1 session), esophageal tumor (2 sessions; 1 patient), base of a large polyp post polypectomy (7 sessions; 6 patients), flat sessile polyps (2 sessions; 2 patients), 3 cm villous adenoma (1 session), and malignant colon cancer in a non-surgical candidate (1 session). Hemostasis was observed and lesions obliterated after all sessions, although mass lesions were not rebiopsied. There were no immediate complications. Three months after treatment, one patient with AVM and one with radiation proctitis had ulcers at the site of APC application.Conclusion:AVM s and the lesions in GAVE and radiation proctitis were effectively obliterated by APC,but often required more than one treatment session. Preliminary results of APC treatment in mass lesions are encouraging, but more data are required.APC is safe and easy to perform.