Mo2016 The New Hybrid Argon Plasma Coagulation (Hybrid APC) for Endoscopic Ablation of Barrett's Esophagus (BE): the Results of the Pilot Trial

Kashin, Sergey; Kuvaev, Roman; Nadezhin, Alexander S.; Kraynova, E; Nekhaykova, N. V.

doi:10.1016/j.gie.2016.03.708

Cited by 8 publications

(24 citation statements)

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“…There is a paucity of data on the efficacy of hybrid-APC. Although Kashin et al 16 and Manner et al 15 showed similar results, their mean follow-up after hybrid-APC was only 3 to 4.5 months. The CRIM rate of APC treatment without prior submucosal saline injection varies between 50% and 77%.…”

Section: Discussionmentioning

confidence: 77%

“…In two other recently published retrospective studies on the use of hybrid-APC, the stricture rate was 0% and 2%, respectively. 15,16 A German group showed in a randomized ex-vivo study that prior submucosal saline injection appears to be able to reduce the coagulation depth by half in comparison with standard APC, with no thermal injury to the propria muscularis. 21 This water cushion may explain the lower rate of stricture formation observed with this technique in comparison to traditional APC.…”

Section: Discussionmentioning

confidence: 99%

“…This emerging method combines submucosal saline lift with diffuse tissue thermal ablation. Manner et al 15 and Kashin et al 16 demonstrated that hybrid-APC was safe with a stricture rate of 2% and effective. However, the follow-up period was in both studies only a few months.…”

Section: Introductionmentioning

confidence: 99%

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Safety and long-term efficacy of hybrid-argon plasma coagulation for the treatment of Barrett's esophagus: An Australian pilot study (with video)

Staudenmann

Skacel

Tsoutsman

et al. 2021

Int J Gastrointest Interv

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Background: Five to ten percent of all patients undergoing radiofrequency ablation (RFA), which is the most established technique for Barrett's esophagus (BE) ablation-develop strictures. Hybrid-argon plasma coagulation (APC) combines APC with submucosal saline injection that was recently developed to tackle this problem. The aims of this pilot study were to evaluate the feasibility, tolerance, safety and long-term efficacy of hybrid-APC for the treatment of BE. Methods: Patients with histological proven BE were selected for hybrid-APC. Prior to APC thermal ablation the mucosa was lifted using a submucosal high-pressure water jet injection system (Erbejet 2; Erbe, Tuebingen, Germany). Short-term (< 48 hours) and long-term (> 48 hours) safety were evaluated. Efficacy of ablation was measured at 3, 6, 12 and 24 months at follow-up endoscopy by evidence of macroscopically complete resolution of BE mucosa and/or histologically complete resolution of intestinal metaplasia (CRIM). Results: Eleven patients were included in the study (average age, 68.2 years; male 72.7%). Eight patients (72.7%) were treatment naive, 9.1% (n = 1) had prior RFA and 18.2% (n = 2) had prior endoscopic mucosal resection. Two patients were excluded from the study. Nine patients (100%) had macroscopic remission and 88.9% (n = 8) had macroscopic remission and microscopic CRIM at 24 months after hybrid-APC ablation. No treatmentrelated stricture or other major complications were observed, 1 patient (11.1%) reported minor adverse effects. Conclusion: In this prospective pilot study, hybrid-APC appears safe, feasible and effective after 24 months, which has not been evaluated so far. Further large, multi-centre trials are warranted to confirm the present results.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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Safety and long-term efficacy of hybrid-argon plasma coagulation for the treatment of Barrett's esophagus: An Australian pilot study (with video)

Staudenmann

Skacel

Tsoutsman

et al. 2021

Int J Gastrointest Interv

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“…While other studies by Rösch et al [15] and Pech O et al [17] showed a complete histological remission of BE in 92.50% (74/80). In an investigation that included 12 patients with BE with LGD, 100% achieved histological remission 3 months after completing the ablation with Hybrid.APC [18].…”

Section: Resultsmentioning

confidence: 99%

Treatment of Barrett's esophagus with low-grade dysplasia using Hibrid-APC

Torres¹,

Quintanilla²,

Megias³

et al. 2022

Gastroenterol Hepatol Dig Sys

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Introduction: Barrett's esophagus (BE) with low-grade dysplasia represents a risk of progression towards esophageal adenocarcinoma. Hybrid-APC turns out to be an effective, safe, easy to use and relatively low-cost technique to stop this progression. Aims: to describe the therapeutic response of Hybrid-APC in patients with low-grade dysplasia in Barrett's esophagus. Method: an observational, descriptive investigation of a series of cases was carried out at the National Center for Minimal Access Surgery between December 2018 and December 2020. Twenty patients with BE histologically classified with low-grade dysplasia were included. Ablation with Hybrid APC was applied, and endoscopy was performed three and six months after the end of the treatment. The therapeutic response was evaluated through histological remission and the presence of complications. The information was processed in the statistical program SPSS, version 21. Results: mean age 50.5 (range 27-81 years). 55% (11) are male. Eighty-five percent were asymptomatic and 90% had circumferential BE. 55% (11) required a HybridAPC session. With an average of 1.4 sessions, macroscopic and histological remission without dysplasia was achieved at three and six months in 90% (18/20) and 92.8% (13/14) of the patients respectively, without witnessing complications. Conclusions: endoscopic treatment with the Hybrid-APC has a good therapeutic response, with a good histological remission and without complications, in patients with low-grade dysplasia in BE.

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“…HybridAPC as a combination of needle-free waterjet injection and argon plasma is mainly used for treatment modalities in the GI tract [13][14][15][16][17]: a fine jet of water is first used to elevate the tissue (step 1) with the potential to protect the underlying structures from thermal energy of APC which can be applied afterwards through the same instrument (step 2).…”

Section: Introductionmentioning

confidence: 99%

Hybrid argon plasma coagulation (HybridAPC) versus sharp excision for the treatment of endometriosis: a prospective randomized clinical trial

Keckstein

Brunecker

et al. 2022

Arch Gynecol Obstet

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Purpose Endometriosis is a benign, but potentially serious gynaecological condition in terms of abdominal pain and impaired fertility. Laparoscopic excision techniques are considered the therapeutic standard. HybridAPC is presented as a novel technique for the non-contact thermal ablation of peritoneal endometriosis with simultaneous protection of the underlying thermosensitive structures by creating a needle-free elevated fluid cushion which enables a safer exposure and distance, as well as potentially improved peritoneal conditioning prior to APC. Methods In this prospective randomized clinical trial, 39 patients with 132 superficial endometriotic lesions in total were treated with HybridAPC or sharp excision in an initial laparoscopic procedure according to randomization. In a second-look laparoscopy, adhesion formation was rated macroscopically. Histologic samples were taken from previously treated areas for evaluation of eradication rate. Results The eradication rate was not significantly different between HybridAPC treatment and sharp excision (65 vs. 81%, p = .55). Adhesions formed in 5% of HybridAPC-treated lesions and in 10% after sharp excision (p = .49). HybridAPC treatment was significantly faster than sharp excision (69 vs. 106 s, p < .05). No intra- and postoperative complications were registered. Conclusion This clinical trial demonstrates the feasibility of this novel surgical technique with a promising impact on adhesion prevention. Compared to sharp excision, HybridAPC is likely to be a safe, tissue-preserving, and fast method for the treatment of peritoneal endometriosis.

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Mo2016 The New Hybrid Argon Plasma Coagulation (Hybrid APC) for Endoscopic Ablation of Barrett's Esophagus (BE): the Results of the Pilot Trial

Cited by 8 publications

References 0 publications

Safety and long-term efficacy of hybrid-argon plasma coagulation for the treatment of Barrett's esophagus: An Australian pilot study (with video)

Safety and long-term efficacy of hybrid-argon plasma coagulation for the treatment of Barrett's esophagus: An Australian pilot study (with video)

Treatment of Barrett's esophagus with low-grade dysplasia using Hibrid-APC

Hybrid argon plasma coagulation (HybridAPC) versus sharp excision for the treatment of endometriosis: a prospective randomized clinical trial

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