Argon plasma coagulation: Clinical experience in pediatric patients.
BACKGROUND
Argon plasma coagulation has potential advantages in pediatric endoscopy.


METHODS
Argon plasma coagulation was applied in 13 children (age 0.05-17 years; median 3 years) with significant comorbid conditions including immunosuppression, chemotherapy, acute or chronic organ failure, and coagulopathy. Twelve had bleeding lesions; esophageal granulomatous tissue was coagulated in one. The bleeding lesion was located in the stomach in 9 of 12, the duodenum in 2 of 12 (both with granulomatous tissue), and at an enterocolonic anastomosis in 1 of 12.


METHODS
In total, 23 procedures were performed, 22 for bleeding (range 1-5 per patient). Hemostasis was achieved in 8 of 12 with one session. Blood loss and transfusion requirement were reduced in 3 of the other 4 patients. Blood loss was not affected in 1. Bleeding recurred in 3 of 12, and additional procedures were performed in 7 of 12. Granulomatous tissue was completely eradicated in 2 of 3; in one, granulomatous tissue associated with surgical staples was only partially removed. Complications occurred in 2 of 13 patients and included submucosal argon gas and scar formation.


CONCLUSIONS
Endoscopic argon plasma coagulation is efficacious for hemostasis and tissue ablation in pediatric patients. Minor complications occurred in 17% (2/13) of cases in this series.
Khan
Khalid
K
Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA.
Schwarzenberg
Sarah Jane
SJ
Sharp
Harvey
H
Weisdorf-Schindele
Sally
S
D000293:Adolescent; D001128:Argon; D002648:Child; D002675:Child, Preschool; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000601:surgery*; D016558:Hemostasis, Endoscopic / Q000379:methods; D006801:Humans; D007223:Infant; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome
D001128:Argon