Argon plasma coagulation and radiofrequency ablation in nonvariceal upper gastrointestinal bleeding

Mendonça, Ernesto Quaresma; Oliveira, Joel Fernandez de; Maluf‐Filho, Fauze

doi:10.1016/j.tgie.2016.12.010

Cited by 3 publications

(3 citation statements)

References 45 publications

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“…Injections of the fluid were made in quadrants around the ulcer's base. The goal was to cause local vasoconstriction and a tamponade effect to reduce blood flow to the affected area (9) .…”

Section: Methods Of Endoscopy Treatment: I) Epinephrine Injection The...mentioning

confidence: 99%

Outcomes of Endoscopic Therapy in Patients with Peptic Ulcer Bleeding

Ibrahim¹,

Alqanduz²,

Barakat³

2022

The Egyptian Journal of Hospital Medicine

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Background: The use of endoscopy is crucial in the treatment of bleeding from peptic ulcers. Objective: To evaluate the clinical, laboratory, and endoscopic findings related to poor prognosis and to analyze the outcomes related to the treatment of peptic ulcer bleeding with different methods of endoscopic therapy. Patients and Methods: Thirty patients who underwent endoscopic treatment and were diagnosed with peptic ulcer bleeding at

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“…Injections of the fluid were made in quadrants around the ulcer's base. The goal was to cause local vasoconstriction and a tamponade effect to reduce blood flow to the affected area (9) .…”

Section: Methods Of Endoscopy Treatment: I) Epinephrine Injection The...mentioning

confidence: 99%

Outcomes of Endoscopic Therapy in Patients with Peptic Ulcer Bleeding

Ibrahim¹,

Alqanduz²,

Barakat³

2022

The Egyptian Journal of Hospital Medicine

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“…Argon plasma coagulation (APC) is an electrosurgical monopolar procedure that has been well established as an effective and safe modality for endoscopically managing a variety of gastrointestinal conditions involving hemostasis and ablation. Its application has been demonstrated in the electrocoagulation of angiodysplastic lesions, gastric antral vascular ectasia (GAVE) syndrome, radiation telangiectasias, and ulcer hemostasis, as well as in ablative treatments of Barrett’s esophagus and esophageal, gastric, and colonic tumors 1 2 3 4 5 .…”

Section: Introductionmentioning

confidence: 99%

“…well as in ablative treatments of Barrett's esophagus and esophageal, gastric, and colonic tumors [1][2][3][4][5].…”

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confidence: 99%

Spray coagulation with snare-tip versus argon plasma coagulation: An ex vivo study evaluating tissue effects

et al. 2021

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Background and study aims Argon plasma coagulation (APC) is an effective and safe modality for many gastrointestinal conditions requiring hemostasis and/or ablation. However, it can be quite costly. A potentially more cost-effective alternative is snare-tip spray coagulation (SC). This study aimed to determine whether SC would be a safe and effective alternative to APC using an ex-vivo model. Methods Using two resected porcine stomach, 36 randomized gastric areas were ablated for 2 seconds with either APC at 1.0 L/min 20 W (APC20) and 1.4 L/min 40 W (APC40) or SC with Effect 2 60 W (SC60) and 80 W (SC80) from 3 mm. Extent of tissue injury was then analyzed histopathologically. Results The mean coagulation depth was 790 ± 159 µm and 825 ± 467 µm for SC60 (n = 9) and SC80 (n = 8), respectively. This was compared to 539 ± 151 µm for APC20 (n = 8) and 779 ± 267 µm for APC40 (n = 9). Mean difference (MD) in coagulation depth between SC60 and APC40 was 12 µm (95 % confidence interval [CI], –191 to 214 µm; P = 0.91) and was 47 µm (95 %CI, –162 to 255 µm; P = 0.81) between SC80 and APC40. There was a greater depth of injury with APC40 (MD, 240 µm; 95 %CI, 62 to 418 µm; P = 0.04) and with SC60 (MD, 252 µm; 95 %CI, 141 to 362 µm; P = 0.004) when compared to APC20. Mean cross-sectional area of coagulation was 2.39 ± 0.852 mm² for SC60 and 2.54 ± 1.83 mm² for SC80 compared to 1.22 ± 0.569 mm² for APC20 and 1.99 ± 0.769 mm² for APC40. Seventy-eight percent reached the muscularis mucosa (MM) and 11 % the submucosa in the SC60 group compared to 50 % and 38 % in SC80 and 56 % and 11 % in APC40, respectively. Thirty-eight percent of APC20 specimens reached the MM. The muscularis propria was unaffected. Conclusions This small ex-vivo study suggests that SC60 and SC80 may be safe alternatives to APC40 with comparable coagulation depths and area effects.

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