Argon plasma coagulation for the treatment of superficial esophageal carcinoma.
OBJECTIVE
Recently, endoscopic mucosal resection (EMR) has become the first choice of treatment for superficial esophageal cancer without metastasis. However, EMR is not safe for all patients. Argon plasma coagulation (APC) is a noncontact electrocoagulation technique that creates tissue damage. The risk of bleeding may be lower with APC than with EMR. Therefore, we selected APC for the treatment of patients with superficial esophageal cancer who could not undergo EMR. The aim of the present study was to describe these cases and analyze the results of this treatment.


METHODS
Ten patients with superficial esophageal cancer underwent APC at our institution from February 2001 through January 2002. None of the patients could undergo EMR because of complications. Ablation was performed using an APC probe (ERBE APC probe; ERBE Elektromedizin, Tübingen, Germany), a high-frequency electrosurgical generator (ERBE ICC200), and an argon delivery unit (ERBE APC 300). All patients had uneventful recoveries.


RESULTS
No incidents of bleeding from the ablated lesion or infection occurred. Oral intake was resumed on the day after treatment. The mean duration of the procedure was 20 minutes (range, 10 to 40 minutes). Disease recurred in two patients. Two patients died of laryngeal cancer and liver failure, respectively.


CONCLUSIONS
APC is a safe and easy to perform procedure, but the effect of therapy is inferior to that of EMR in terms of the complete resection of the lesion. In conclusion, APC should be limited to cases of superficial esophageal cancer without metastasis in which EMR has been deemed difficult.
Nomura
Tsutomu
T
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. nomura-t@nms.ac.jp
Miyashita
Masao
M
Makino
Hiroshi
H
Maruyama
Hiroshi
H
Katsuta
Miwako
M
Kashiwabara
Moto
M
Takahashi
Ken
K
Sasajima
Koji
K
Yamashita
Kiyohiko
K
Tajiri
Takashi
T
D000368:Aged; D001128:Argon / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004564:Electrocoagulation / Q000379:methods*; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D019990:Perioperative Care; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D016896:Treatment Outcome
D001128:Argon