New generation argon plasma coagulation in flexible endoscopy: ex vivo study and clinical experience.
OBJECTIVE
A new argon plasma coagulation (APC) system was developed to improve the conduction characteristics of existing systems and to achieve a true non-contact procedure. We evaluated the new system in an ex vivo experiment and in two different clinical cases.


METHODS
Swine gastric walls were cauterized at various current settings and time intervals. The diameter and penetration depth of the cauterized areas were measured. We also describe the use of this method to treat patients with gastric hemorrhagic hereditary telangiectasias and a mucosal gastric cancer.


RESULTS
The ex vivo study revealed an improved maintenance of current conduction and greater control of the extent and penetration depth of the cauterization effects on tissue using the new APC system. In the clinical cases, hemorrhagic telangiectasias and an early stage gastric cancer were treated successfully without relapse using the new system.


CONCLUSIONS
Improved current conduction and controllability of cauterization corresponding to emission time were demonstrated for the new APC. The new system allows expeditious superficial cauterization of a wide area without any contact with tissue. The therapeutic effect appeared favorable compared with previous APC devices for gastrointestinal applications.
Sumiyama
Kazuki
K
Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan. kaz_sum@jikei.ac.jp
Kaise
Mitsuru
M
Kato
Masayuki
M
Saito
Syouichi
S
Goda
Kenichi
K
Odagi
Isao
I
Tamai
Naoto
N
Tsukinaga
Shintaro
S
Matsunaga
Kazuhiro
K
Tajiri
Hisao
H
D000368:Aged; D000818:Animals; D004195:Disease Models, Animal; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000098:blood supply / Q000601:surgery*; D006801:Humans; D017075:Laser Coagulation / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013552:Swine; D013684:Telangiectasis / Q000473:pathology / Q000601:surgery*