Effects of low-power argon plasma coagulation thermoablation of Barrett's epithelium on oesophageal motility.
BACKGROUND
Oesophageal dysmotility contributes to the pathogenesis of Barrett's epithelium (BE) allowing prolonged mucosal contact with injurious refluxate. Argon plasma coagulation (APC) is effective for BE ablation, but it is unknown whether the procedure affects oesophageal motility.


OBJECTIVE
To assess the effect of low power (30 W) APC therapy on oesophageal motility in patients with BE.


METHODS
Thirty-three patients with at least 4 cm of BE underwent oesophageal manometry before and after APC ablation. All were on proton pump inhibitors. Oesophageal body peristaltic wave duration and amplitude, and lower oesophageal sphincter (LOS) pressure and length were compared before and after treatment.


RESULTS
In a total of 28 men and five women, with a mean age of 63.4 years (range 39-79) and mean BE length 6.5 cm (range 4-19), macroscopic clearance was achieved in 28 patients. A small statistically significant (P<0.05) increase in peristaltic wave amplitude was seen after APC [mean (SD) mmHg before versus after: 30.4 (15.2) versus 36.2 (20.1) at 13.5 cm, 47.6 (27.1) versus 54.5 (26.8) at 8.5 cm, and 51.2 (35.3) versus 58 (34.4) at 3.5 cm above the LOS]. No changes in either peristaltic wave duration or LOS parameters [mean (SD) pressure 10.6 (5.6) versus 10.3 (4.3) mmHg; length 2.8 (1.3) versus 2.8 (1.0) cm] were observed.


CONCLUSIONS
APC ablation of BE at a power setting of 30 W does not impair oesophageal motility.
Basu
Kumar K
KK
Digestive Diseases Centre, University Hospitals of Leicester NHS Trust, Leicester, UK.
Talwar
Vivan
V
de Caestecker
John S
JS
D000328:Adult; D000368:Aged; D000863:Antacids / Q000627:therapeutic use; D001471:Barrett Esophagus / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D003131:Combined Modality Therapy; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D017075:Laser Coagulation; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D010528:Peristalsis; D011184:Postoperative Period; D054328:Proton Pump Inhibitors
D000863:Antacids; D054328:Proton Pump Inhibitors