Endoscopic Induction of Mucosal Fibrosis by Argon Plasma Coagulation (APC) for Esophageal Varices: A Prospective Randomized Trial of Ligation plus APC vs. Ligation Alone

Nakamura, Shinichi; Mitsunaga, Atsushi; Murata, Yoko; Suzuki, Shigeru; Hayashi, Naoaki

doi:10.1055/s-2001-12804

Cited by 71 publications

(52 citation statements)

References 8 publications

(12 reference statements)

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“…Com a incorporação do Argônio a partir da década de 90, tornou-se o método de escolha para o tratamento das anomalias vasculares do sistema digestivo 10,11,12,13,14,15,16 . O plasma de Argônio, por não ser método de contato direto, tem sido o muito utilizado no tratamento de lesões do trato gastrointestinal (esôfago de Barret, varizes, pólipos).…”

Section: Discussionunclassified

Novo método para tratamento da angiodisplasia de cólon

Freitas

Santos

Todeschi

et al. 2009

Rev bras. colo-proctol.

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RESUMO: A utilização da colonoscopia como método de diagnóstico e tratamento possibilitou avanços na abordagem da angiodisplasia de cólon, anomalia vascular responsável por um terço das hemorragias gastrointestinais baixas. Trata-se de paciente com 65 anos, insuficiência renal crônica dialítica e coronariopata grave, apresentando episódios de hematoquezia volumosa ao iniciar uso de agregantes plaquetários, necessitando múltiplas hemotransfusões. Colonoscopia diagnosticou lesões vasculares no ceco, onde existe grande risco de perfuração durante intervenções terapêuticas. Há descrições na literatura do uso de agentes hemostáticos tais como plasma de Argônio e vasoconstrictores, aplicados separadamente. Foi realizado tratamento endoscópico das angiodisplasias com aplicação de Argônio, após elevação das lesões com soro fisiológico, e pela primeira vez descrita no Brasil, acrescentado vasoconstrictor à solução.

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Section: Discussionunclassified

Novo método para tratamento da angiodisplasia de cólon

Freitas

Santos

Todeschi

et al. 2009

Rev bras. colo-proctol.

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“…APC was performed to promote esophageal mucosal fibrosis. EVL combined with APC completely eliminated EVs and prevented their recurrence 13,14) . In summary, this treatment of EVs enabled us to reduce the GCV, probably by rerouting the variceal blood flow to collateral pathways through eradication of the blood flow to EVs.…”

Section: Discussionmentioning

confidence: 99%

Successful endoscopic submucosal dissection for early gastric cancer adjacent to gastric cardia varix

Watanabe

Hikichi

Nakamura

et al. 2016

FJMS

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A 58 -year -old man with liver cirrhosis and renal failure was diagnosed with esophageal varices (EVs) and a gastric cardia varix (GCV) by esophagogastroduodenoscopy (EGD). The patient also exhibited early gastric cancer (EGC) in the upper gastric body adjacent to the GCV. The EVs and GCV were treated using endoscopy before endoscopic submucosal dissection (ESD) of the EGC to prevent variceal bleeding during ESD. Endoscopic variceal ligation (EVL) was performed to treat the EVs. In addition, extra -variceal polidocanol injection and argon plasma coagulation (APC) were performed after EVL. Follow -up EGD two months after APC revealed that the GCV had diminished in size. Then, ESD was performed with polidocanol injection into the submucosa around the GCV to prevent bleeding. During ESD, the EGC was resected en bloc without severe bleeding. Complications were not observed after ESD. Histopathological examination of the ESD specimens indicated that the resection was curative.

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“…It is suggested to maintain an operative distance of 2 to 8 mm from probe to tissue, and performed by applications of 0.5 to 2 seconds duration (Grund, Nakamura) [4,5]. The theoretical advantages of APC include its ease of application, rapid treatment of multiple lesions in the case of arteriovenous malformations or wide areas (the base of resected polyps or tumor bleeding), safety due to reduced depth of penetration, and lower cost compared to laser (Cohen) [6].…”

Section: Discussionmentioning

confidence: 99%

APC Treatment Resulting in Pneumoperitoneum; Perforation or Just Escape of Luminal Gas?

Patel¹,

Chauhan²,

Amin³

2017

J Clin Gastroenterol Hepatol

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Argon plasma coagulation (APC) is an electrocoagulation technique commonly used for treatment of gastrointestinal bleeding secondary to arteriovenous malformations (AVMs). Although this modality is generally safe, a rare complication reported is perforation. We present an elderly female, who was found to have multiple colonic AVMs which were treated with APC, however, resulted in complication of pneumoperitoneum. With absence of peritonitis and hypotension, patient was treated with needle decompression of the peritoneal space, bowel rest, and antibiotics, which resulted in a successful recovery in the absence of surgical intervention.

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Endoscopic Induction of Mucosal Fibrosis by Argon Plasma Coagulation (APC) for Esophageal Varices: A Prospective Randomized Trial of Ligation plus APC vs. Ligation Alone

Cited by 71 publications

References 8 publications

Novo método para tratamento da angiodisplasia de cólon

Novo método para tratamento da angiodisplasia de cólon

Successful endoscopic submucosal dissection for early gastric cancer adjacent to gastric cardia varix

APC Treatment Resulting in Pneumoperitoneum; Perforation or Just Escape of Luminal Gas?

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