Argon plasma coagulation in the right and left colon: safety-risk profile of the 60W-1.2 l/min setting.
OBJECTIVE
The 40W-0.8 l/min setting is widely recommended for argon plasma coagulation (APC) in the right colon. Until March 2012, we used the 60W-1.2 l/min setting for all sites of the colon. By auditing our experience, we assessed the safety-risk profile of the 60W-1.2 l/min setting in the right and left colon.


METHODS
All cases treated with APC by a single endoscopist, using the 60W-1.2 l/min setting for all sites of the colon between October 2001 and December 2007 were identified retrospectively and site, type, number of lesions, and complications were recorded. Between January 2008 and March 2012, information was recorded prospectively.


RESULTS
In the retrospective audit, 290 lesions (101 cecum/ascending, 120 sigmoid/descending, 69 transverse) were treated in 241 patient endoscopies. There were no perforations. In the prospective audit, 156 lesions (83 cecum/ascending, 47 sigmoid/descending, 26 transverse) were treated in 132 patient endoscopies. There was 1/83 (1.2%) perforation in the cecum/ascending colon and none in the transverse or sigmoid/descending (n.s.). Combined, the results yield a cecal/ascending perforation rate of 1/153 (0.6%) patient endoscopies, 1/184 (0.5%) lesions treated and overall perforation rate for all sites of the colon of 1/373 (0.3%) patient endoscopies and 1/446 (0.2%) lesions. Post-polypectomy syndrome and delayed bleeding each occurred in 3/373 (0.8%) patient endoscopies and 3/446 (0.7%) lesions. There were no deaths.


CONCLUSIONS
In the cecum and ascending colon, the APC perforation rate at the 60W-1.2 l/min setting was no higher than in the left colon and is similar to that reported in previously published series. Therefore, it appears safe, provided the precautions we describe are strictly followed.
Department of Gastroenterology, Euroclinic of Athens , Athens , Greece.
Marios Z
MZ
Panos
Andriani
A
Koumi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016888:Angiodysplasia / Q000601:surgery; D057908:Argon Plasma Coagulation / Q000009:adverse effects* / Q000379:methods*; D002432:Cecum / Q000601:surgery*; D003106:Colon / Q000601:surgery*; D044682:Colon, Ascending / Q000601:surgery; D044683:Colon, Descending / Q000601:surgery; D012809:Colon, Sigmoid / Q000601:surgery; D044684:Colon, Transverse / Q000601:surgery; D003111:Colonic Polyps / Q000601:surgery; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology*; D011446:Prospective Studies; D012189:Retrospective Studies; D055815:Young Adult