Prospective Evaluation of a New High Power Argon Plasma Coagulation System (VIO APC) in Gastrointestinal Endoscopy: Experience with 216 Patients

Abstract

Prospective Evaluation of a New High Power Argon Plasma Coagulation System (VIO APC) in Gastrointestinal Endoscopy: Experience with 216 Patients Hendrik Manner, Andrea May, Thomas Rabenstein, Lars Nachbar, Oliver Pech, Markus D. Enderle, Christian Ell Background: We sought to evaluate the safety and efficacy using a new high power argon plasma coagulation system (hp-APC) in the gastrointestinal tract.Methods: From 02/2005 to 06/2005, 216 patients (167 males (77.3%); mean age 66 G 11 years) were treated using hp-APC in a total of 275 sessions. In various indications (additive ablation therapy in curative intention in early Barrett’s cancer (132 patients); palliative treatment of esophageal cancer (n Z 20); gastric polyps/cancer (n Z 17); angiodysplasia (n Z 16); Zenker’s diverticulum (n Z 8); duodenal adenomas (n Z 7); and other), the new VIO APC device (VIO 300 D with APC 2; ERBE Elektromedizin, Tubingen, Germany) was used (pulsed APC; 15-120 W). Pushand-Pull Enteroscopy using double-balloon technique (PPE; new 1.5 mm APC probes) was used in 11 patients (5.1%). Safety and efficacy of hp-APC were recorded after each individual treatment session. Results: The mean number of treatment sessions required using hp-APC in various indications was 1.7 (1-5). For palliative tumor ablation therapy in the esophagus, it was 2.3 (1-5). Minor complications (pain, dysphagia, irritation of the intestinal wall) were observed in 24/216 patients (11.1%), major complications (gas accumulation in the intestinal wall, perforation, stenosis) in 5 patients (2.3%). Conclusions: Hp-APC appears to be safe and effective. Due to a low number of treatment sessions required, the VIO APC device might be used as an alternative to Nd:YAG laser in tumor debulking. Using the new 1.5 mm probes for PPE, hp-APC was effective in the treatment of GI bleeding.