[Endoscopic argon plasma thermo-coagulation of Barrett's esophagus using different powers: histopathological and post procedure symptons analysis].
OBJECTIVE
To establish the ideal power to be employed in order to get the effective ablation and the lowest rate of symptoms at argon plasma thermocoagulation in Barrett's esophagus (BE).


METHODS
Twenty-eight asymptomatic patients with BE, were randomly divided in two groups of different ablation powers, 50W or 70W. After endoscopic ablation and biopsies from the treated area for histological analyses, symptoms were evaluated through a questionnaire answered by phone.


RESULTS
Thirteen patients without specialized columnar metaplasia were excluded and the remaining fifteen patients, seven men (46,7%) and eight women (53,3%), with an average age of 53 years +10,4, composed the two groups: 10 patients at the 70W power and 5 at the 50W power group. There was no significant difference between the groups regarding age, BE extent, percentage of coagulated esophageal circumference and the duration of symptoms. Pain was the most important symptom, with a mean duration of 10,3 + 9,7 days. When power was compared to symptoms, although not statistically significant, a moderate negative correlation was noted. Endoscopic biopsies showed ablation restricted to the mucosa's superficial layer in 40% of the cases in the lower power group, and only 10% in the higher power group, although deeper layers of the mucosa were compromised. There were no statistical significant differences when comparing the different powers to the penetration through the mucosa's layers and the symptoms.


CONCLUSIONS
There are evidences that the 70W potency argon plasma coagulation for BE leads to a lower incidence of residual specialized columnar metaplasia under the new scamous epithelium.
Dotti
Vanessa Puccinelli
VP
Clínica Cirúrgica, Universidade Federal do Paraná, Curitiba, PR, Brasil. anpucci@uol.com.br
Baretta
Giorgio Alfredo Pedroso
GA
Yoshii
Sérgio Ossamu
SO
Ivano
Flávio Heuta
FH
Ribeiro
Hugo Daniel Welter
HD
Matias
Jorge Eduardo Fouto
JE
D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology* / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D017075:Laser Coagulation; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies