Safety and efficacy of argon plasma coagulator ablation therapy for flat colorectal adenomas.
BACKGROUND
argon-plasma coagulation (APC) has been used safely and efficaciously in multiple settings including colon polyp treatment. The aim of this study was to evaluate APC efficacy and safety in the treatment of flat colorectal adenomas.


METHODS
APC ablation was prospectively performed and evaluated in 22 consecutive patients with colorectal adenomas, 11 of which had large sessile adenomas that were treated with piecemeal polypectomy and APC ablation of residual adenomatous tissue, whereas the remaining eleven patients with flat or carpet-like adenomas were only treated with APC. The mean initial longitudinal extension of adenomas to be treated with APC was 22 mm (range, 20 to 40 mm).


RESULTS
the mean age of patients was 70 years. Adenomas were found most frequently in the rectum (50%) and cecum (23%). Complete ablation was achieved in 90.9% of adenomas. Recurrence was observed in 20% of patients, all of them in the rectum, after a mean follow-up period of 16.3 months (range, 8 to 35). All recurrences were managed satisfactorily. No major complications were seen.


CONCLUSIONS
argon plasma coagulator ablation of flat colorectal adenomas is an efficacious and safe technique, specially in the right colon, but results must be confirmed in controlled trials with a higher number of patients.
García
A
A
Unit of Gastrointestinal Endoscopy, Department of Digestive Diseases, Hospital Gregorio Marañón, Madrid, Spain.
Núñez
O
O
González-Asanza
C
C
Parera
A
A
Menchén
L
L
Ripoll
C
C
Senent
C
C
Cos
E
E
Menchén
P
P
D000236:Adenoma / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007417:Intestinal Polyps / Q000601:surgery*; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies