Argon Plasma Coagulation Is Appropriate for the Treatment of LD0.3Rf Type Esophageal Varices

Abstract

Introduction: Esophageal variceal bleeding (EVB) is the most common complication of liver cirrhosis. Endoscopic injection sclerotherapy (EIS) and endoscopic band ligation (EBL) are the two effective and popular method for dealing with EVB. However, conditions would be difficult for EIS or EBL, when it occurred to LD0.3Rf type esophageal varices. Fortunately, Argon Plasma Coagulation (APC), as a non-contact coagulation method has already been used for hemostasis and tissue coagulation, and is proved to achieving an satisfying effect. Hence, in this study, we aimed to confirmed the efficacy and safety of APC, when applied in the treatment for LD0.3Rf type esophageal varices. Methods: Clinical data of patients with LD0.3Rf esophageal varices and received APC for treatment, in our hospital, during the period of 2007 to 2018, were retrospective analyzed.2799_A Figure 1. Procedure of applying Argon Plasma Coagulation for the Treatment of LD0.3Rf Type Esophageal varices2799_B Figure 2. Recurrent bleeding rate of Argon Plasma Coagulation Treatment for LD0.3Rf type esophageal varicesResults: A total of 14 patients were included, 9 were male and 5 were female, with a mean age of 53.14±10.12 (43-75 years old). The main cause of liver cirrhosis was viral hepatitis (71.4%), and 78.6% of the patients got an Child-puge A type liver function. All of the patients underwent APC for treatment successfully, and none of them occurred bleeding and perforation during the procedure. While, 2 patients suffering fever, other 2 complained chest and epigastric pain and 1 patient felt a little dysphagia. All the 5 patients got recovered soon, and no severe complications happened. As for the effect of APC, rate of recurrent bleeding were observed during an mean 17 months follow up (ranging from 3 to 48 months). There was only one patient occurred re-bleeding 3 months post the operation and was given EIS for treatment. The recurrent bleeding rates of intra-operative and 3, 6, 12, 24, 36, 48 months post-operative were as follows: 0%(0/14), 7.69%(1/13), 0%(0/12), 0%(0/12), 0%(0/7), 0%(0/7), 0%(0/5). Conclusion: APC is of great value for esophageal varices eradication and preventing their recurrence, especially when dealing with LD0.3Rf type. Its effect and safety is sure to be satisfying, while large sample studies still needed.2799_C Figure 3. Characteristics of the LD0.3Rf type esopageal varices patients (14cases)