Effects of argon plasma coagulation on human stomach tissue: An ex vivo study.

Abstract

Argon plasma coagulation (APC) is a safe alternative treatment for gastrointestinal neoplasms and precancerous lesions. However, the extent of thermal damage after APC is difficult to predict. We investigated the effects of APC on human stomach tissue. Argon plasma coagulation was performed on 10 freshly resected human stomachs that were obtained after total gastrectomy. The effects on tissue were compared across power settings (40, 60, and 80W), durations (5, 10, 15, 20, and 25s), and between injection (submucosal injection of normal saline) and control (without injection) groups. Success was defined as complete mucosal necrosis without damaging the muscularis propria. Without submucosal injection, the incidence of damaging the muscularis propria increased as the power and duration increased. Tissue damage in the injection group was mostly confined to the submucosa, even when using the high-power setting. In the injection group, ablations at 40W for 20s, 60W for 15s, and 80W for 15 or 20s produced success rates ≥80%. In the control group, ablations at 60W for 10s, and 80W for 5, or 10s produced success rates ≥80%. The optimal energy levels to achieve complete mucosal and submucosal necrosis without damaging the muscularis propria were 800-1600 and 600-800J in the injection and control groups, respectively. Application of APC produces good results with a low risk of perforation.