Prospective evaluation of a new high-power argon plasma coagulation system (hp-APC) in therapeutic gastrointestinal endoscopy.
OBJECTIVE
The aim of this study was to prospectively evaluate a new high-power argon plasma coagulation system (hp-APC) in therapeutic gastrointestinal (GI) endoscopy.


METHODS
From February to June 2005, 216 patients (167 M (77.3%), mean age 66 years) underwent treatment with hp-APC in a total of 275 sessions. Main indications were additive ablation therapy in Barrett's esophagus, palliative treatment of esophageal cancer, gastric polyps/carcinomas, angiodysplasias, Zenker's diverticula, and duodenal adenomas. The new hp-APC device (VIO 300 D with APC 2) was used (15-120 W) in upper GI endoscopy, push-enteroscopy, and double-balloon enteroscopy.


RESULTS
The mean number of treatment sessions required was 1.7 (1-5). For palliative tumor ablation in the esophagus, the number of sessions was 2.3 (1-5). Minor complications (pain, dysphagia, neuromuscular irritation, asymptomatic gas accumulation in the intestinal wall) were observed in 29/216 patients (13.4%). Major complications (perforation, stenosis occurred) in 2 patients (0.9%).


CONCLUSIONS
Hp-APC appears to be safe and effective in the treatment of various GI condition using different types of endoscopes including double-balloon enteroscopy. Because of the low number of treatment sessions required, hp-APC could be used as an alternative to Nd:YAG laser treatment in tumor debulking.
Manner
Hendrik
H
Department of Internal Medicine II, HSK Wiesbaden, Wiesbaden, Germany. HSManner@gmx.de
May
Andrea
A
Rabenstein
Thomas
T
Pech
Oliver
O
Nachbar
Lars
L
Enderle
Markus D
MD
Gossner
Liebwin
L
Ell
Christian
C
D000236:Adenoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016888:Angiodysplasia / Q000601:surgery; D001128:Argon / Q000009:adverse effects / Q000627:therapeutic use*; D001471:Barrett Esophagus / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D017115:Catheter Ablation; D004379:Duodenal Neoplasms / Q000601:surgery; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000473:pathology / Q000601:surgery*; D005858:Germany; D006801:Humans; D007417:Intestinal Polyps / Q000601:surgery; D017075:Laser Coagulation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000601:surgery
D001128:Argon