BACKGROUND AND AIM: Argon plasma coagulation (APC) is a safe alternative treatment for gastrointestinal neoplasms and precancerous lesions. However, the extent of thermal damage after APC is difficult to predict. We investigated the effects of APC on human stomach tissue. METHODS: Argon plasma coagulation was performed on 10 freshly resected human stomachs that were obtained after total gastrectomy. The effects on tissue were compared across power settings (40, 60, and 80 W), durations (5, 10, 15, 20, and 25 s), and between injection (submucosal injection of normal saline) and control (without injection) groups. Success was defined as complete mucosal necrosis without damaging the muscularis propria. RESULTS: Without submucosal injection, the incidence of damaging the muscularis propria increased as the power and duration increased. Tissue damage in the injection group was mostly confined to the submucosa, even when using the high-power setting. In the injection group, ablations at 40 W for 20 s, 60 W for 15 s, and 80 W for 15 or 20 s produced success rates ≥80%. In the control group, ablations at 60 W for 10 s, and 80 W for 5, or 10 s produced success rates ≥80%. The optimal energy levels to achieve complete mucosal and submucosal necrosis without damaging the muscularis propria were 800-1600 and 600-800 J in the injection and control groups, respectively. CONCLUSION: Application of APC produces good results with a low risk of perforation.
BACKGROUND AND AIM: Argon plasma coagulation (APC) is a safe alternative treatment for gastrointestinal neoplasms and precancerous lesions. However, the extent of thermal damage after APC is difficult to predict. We investigated the effects of APC on human stomach tissue. METHODS:Argon plasma coagulation was performed on 10 freshly resected human stomachs that were obtained after total gastrectomy. The effects on tissue were compared across power settings (40, 60, and 80 W), durations (5, 10, 15, 20, and 25 s), and between injection (submucosal injection of normal saline) and control (without injection) groups. Success was defined as complete mucosal necrosis without damaging the muscularis propria. RESULTS: Without submucosal injection, the incidence of damaging the muscularis propria increased as the power and duration increased. Tissue damage in the injection group was mostly confined to the submucosa, even when using the high-power setting. In the injection group, ablations at 40 W for 20 s, 60 W for 15 s, and 80 W for 15 or 20 s produced success rates ≥80%. In the control group, ablations at 60 W for 10 s, and 80 W for 5, or 10 s produced success rates ≥80%. The optimal energy levels to achieve complete mucosal and submucosal necrosis without damaging the muscularis propria were 800-1600 and 600-800 J in the injection and control groups, respectively. CONCLUSION: Application of APC produces good results with a low risk of perforation.
Authors: Lea Fayad; Andreas Oberbach; Michael Schweitzer; Frederic Askin; Lysandra Voltaggio; Tatianna Larman; Markus Enderle; Hartmut Hahn; Mouen A Khashab; Anthony N Kalloo; Vivek Kumbhari Journal: Endosc Int Open Date: 2019-11-25
Authors: Roberta Maselli; Paul J Belletrutti; Marco Spadaccini; Piera Alessia Galteri; Thomas Stäbler; Michael Ederer; Alexander Neugebauer; Markus D Enderle; Alessandro Repici Journal: Ann Gastroenterol Date: 2021-09-14
Authors: Gian Eugenio Tontini; Lorenzo Dioscoridi; Alessandro Rimondi; Paolo Cantù; Flaminia Cavallaro; Aurora Giannetti; Luca Elli; Luca Pastorelli; Francesco Pugliese; Massimiliano Mutignani; Maurizio Vecchi Journal: Endosc Int Open Date: 2022-04-14