The tissue effect of argon plasma coagulation on esophageal and gastric mucosa.
BACKGROUND
Argon plasma coagulation is a diathermy-based non-contact therapeutic endoscopic modality that may have a lower risk of perforation than other tissue ablation techniques.


METHODS
Its effect was studied on three fresh esophageal and three fresh gastric resection specimens using power settings from 40 to 99 Watts at 90 degrees, with 1 mm separation using pulse durations of 1 and 3 seconds. A scoring system for depth of tissue damage was created and samples were analyzed blindly by a gastrointestinal histopathologist.


RESULTS
There was significantly greater damage to gastric tissue using a 3-second (compared with 1-second) pulse (p = 0.003) and marginally significantly greater damage to esophageal tissue using the 3-second pulse (p = 0.053). Tissue damage was related to power setting for gastric (p = 0.031) but not for esophageal tissue (p = 0. 065). Only 1 of 42 esophageal samples and 2 of 42 gastric samples examined showed damage extending into the muscularis propria.


CONCLUSIONS
Deep tissue damage that could lead to perforation was rare with argon plasma coagulation. The depth of gastric mucosal damage increased with increased pulse duration and increasing power settings, and, although the depth of esophageal mucosal damage was marginally related to pulse duration, it was not related to the power setting. (Gastrointest Endosc 2000;52:342-5).
Watson
J P
JP
Department of Gastroenterology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
Bennett
M K
MK
Griffin
S M
SM
Matthewson
K
K
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D016145:Endoscopy, Digestive System; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D004939:Esophageal Perforation / Q000517:prevention & control; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology* / Q000601:surgery; D007431:Intraoperative Complications / Q000517:prevention & control; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*