Safety and efficacy of a new high power argon plasma coagulation system (hp-APC) in lesions of the upper gastrointestinal tract

BackgroundThe aim of this study was to analyze safety and efficacy of a new high power argon plasma coagulation system in the upper gastrointestinal tract.MethodsData of 215 patients treated with a high power argon plasma coagulation system in the upper gastrointestinal tract 04/2003–01/2004, using a VIO APC device (VIO 300 D with APC 2; Erbe Elektromedizin, Tübingen, Germany; pulsed argon plasma coagulation, 20–120 W), were reviewed and analyzed. Indications were as follows: additive ablation therapy in curative treatment of early Barrett's cancer (122 patients); palliative treatment of oesophageal cancer (n = 27); gastric adenoma/carcinoma (n = 19); Zenker's diverticulum (n = 8); and other. In 190/215 patients (149 males; mean age 67 years), the data were completely analyzable. Minor and major complications were evaluated.ResultsMinor complications (odynophagia, pain, fever) occurred in 24/277 sessions (8.7%); major complications (stenosis) in 3/277 sessions (1.1%) using at least 50 W. No perforation or bleeding occurred. The mean number of treatment sessions required was 1.46 (1–7); in the palliative treatment of oesophageal cancer, it was 2.5 (1–5).ConclusionsThe high power argon plasma coagulation system was effective and safe in various gastrointestinal conditions. Due to it's high effectiveness and a low number of sessions required in tumour debulking, this high power argon plasma coagulation system might be used as an alternative to Nd:YAG laser.