Effectiveness Of Argon Plasma Coagulation Research Articles

Comparing the effects of argon plasma coagulation and interferon therapy in patients with vaginal intraepithelial neoplasia: a single-center retrospective study

PurposeThis study aimed to evaluate the clinical efficacy and safety of argon plasma coagulation (APC) therapy and interferon therapy in patients with grade I and II vaginal intraepithelial neoplasia (VaIN).MethodsA total of 112 patients with VaIN were diagnosed via colposcopy-induced biopsy and classified into the APC group (n = 77) and interferon group (n = 35). Clinical data including age, grade, symptoms, historical or concomitant neoplasia of the lower genital tract, indications for hysterectomy, pregnancy history, cytology, human papillomavirus (HPV) subtype, treatment modalities, and clinical outcomes were analyzed, retrospectively. Complications and clinical outcomes were assessed at 6- and 12-month follow-ups.ResultsThere was no significant difference in the HPV clearance rate between the APC (53.42%) and interferon (33.33%) groups at 6 months after treatment. However, the 12-month follow-up of the APC group showed a significantly higher HPV clearance rate as compared to the interferon group (87.67% vs. 51.52%, P < 0.05). The APC group exhibited a significantly higher cure rate (79.22% vs. 40.0%) and lower persistence rate (12.99% vs. 37.14%) than the interferon group (P < 0.05). Adverse reaction analysis revealed that the primary reaction in the APC group was vaginal drainage, in contrast to the increased vaginal discharge in the interferon group; though the difference was significant (68.83% vs. 28.57%, P < 0.05), no serious complications were observed.ConclusionsTreatment with APC is a safe and more effective procedure against VaIN I and II, compared to interferon. APC may serve as a viable alternative to other physiotherapies.

Effectiveness of argon plasma coagulation in the treatment of weight regain after roux-y gastric bypass: a cross-sectional prospective observational study

Introduction: Roux-en-Y Gastric Bypass (RYGB) is one of the most commonly performed surgeries to treat obesity worldwide. However, approximately 20% of patients have a recurrence of obesity, and enlargement of the gastrojejunal anastomosis is one of the associated factors. Endoscopic treatment of anastomosis has been proposed for further weight loss. One of the most commonly used techniques for anastomotic narrowing is argon plasma coagulation (APC). However, no randomized controlled trials have proven that this technique is superior to multidisciplinary follow-up. Objective: To evaluate and investigate the efficacy and safety of the application of argon plasma in the gastrojejunal anastomosis in the relapse of obesity after Gastric Bypass. Methods: Transversal study. Thirty-two patients were selected. More than 50% of The excess body weight regained was lost. Ranging from 6 to 25 kg. Results: A loss of more than 50% of the excess weight regained was observed in 30 % patients. Ranging from 6 to 25 kg. Conclusion: The application of argon plasma coagulation was safe and effective in the treatment of obesity recurrence after gastric bypass.

Argon plasma coagulation: an effective treatment for solitary rectal ulcer syndrome.

Solitary rectal ulcer syndrome (SRUS) is a very rare benign defecation disorder characterized by distinct clinical features and histological findings. Conventional measures are often shown to be ineffective for the treatment of ulcers. Argon plasma coagulation (APC) has recently been shown to be an effective treatment method for SRUS that is refractory to conventional therapy. Determine the efficacy of APC treatment for patients suffering from SRUS. Prospective, single center. Gastroenterology department at a military hospital in Pakistan. This prospective study included patients with symptoms of rectal bleeding diagnosed with SRUS. Patients were recruited on the basis of clinical, sigmoidoscopic, and histological findings from September 2022 to March 2023. All patients had received conventional treatment initially and were assessed for persistence of symptoms. APC was performed only for those patients who were refractory to standard treatment. Effectiveness of APC for resistant SRUS. 99 patients. The 99 patients diagnosed with SRUS had a median (minimum-maximum) age of patients was 20 (9-41) years. All the patients had undergone conventional treatment, which included the use of laxatives, drinking plenty of water and practicing biofeedback. After this standard treatment, 19 patients (19.19%) recovered fully. However, the remaining 80 patients did not show improvement and underwent APC sessions, out of which 61 patients (76.3%) achieved complete healing of ulcers, while the remaining 19 (23.8%) had no improvement at all. None of the patients reported post session complications. APC is an effective therapy with very promising results for rectal ulcer hemorrhage. It also helps with ulcer healing and alleviates clinical symptoms. However, further controlled investigations are required to consolidate the use of APC in SRUS patients. Single centered.

The effect of argon plasma coagulation on surgical suture material

Introduction. In modern surgery, there are many types of different energy used to achieve hemostasis; one of them is the energy of argon plasma coagulation. However, the impact of energy affects not only the bleeding site; it also affects the stitches lying nearby the source of bleeding. The instructions for the use of a suture material or a coagulation tool do not describe the changes that may occur when they interact. A review of the literature found a small number of publications devoted to changes in the physical properties of suture material when exposed to it. This information is not sufficient to predict the effects of argon plasma coagulation energy on the suture material and, as a result, on wound healing or the quality of the postoperative scar.The objective was to determine changes in the biodestructive properties of synthetic absorbable suture materials with argon plasma coagulation in an in vivo experiment.Methods and materials. In the experimental study, the results of biodegradation of monofilament and polyfilament sutures after exposure to argon plasma coagulation energy were analyzed in comparison with control samples in the body of laboratory mice.Results. It can be unequivocally stated that the effect of argon plasma coagulation energy has an effect on the rate of biodegradation of both monofilament and polyfilament synthetic filaments implanted in muscle tissue.Conclusions. Suture material exposed to argon plasma coagulation may not meet the terms of partial or full biodegradation stated by the manufacturer, which may affect the quality of scar formation.

Methods of endoscopic treatment of chronic radiation proctitis

Aim. To compare the clinical effectiveness of argon plasma coagulation (APC) and radiofrequency ablation (RFA) for the treatment of patients with chronic radiation proctitis (CRP) complicated by recurrent rectal bleeding.Methods. A prospective, randomized, single-center study conducted in the State Medical University of the Loginov Moscow State Medical Scientifi Centre. The study included 73 patients with 1—2 degrees of CLP on the RTOG/EORTC scale. The indication for endoscopic treatment was recurrent rectal bleeding. Endoscopic treatment was performed: APC (36 patients) and RF (37 patients), depending on randomization.Results. In 44 patients (60.2 %), of which 18 (50 %) patients in the APC group and 26 (70.2 %) patients in the RF group, a complete regression of the disease was revealed. Telangiectasia was detected in 18 patients (50 %) in the APC group and in 11 patients (29.7 %) in the RF group, which were a continuing source of bleeding. After regression of inflmmatory changes, the patients underwent the second stage of surgery corresponding to the randomization group. After the second stage of surgery in the APC group in 17 patients (94.4 %) and in the RF group in 11 patients (100 %), a complete regression of the disease was revealed. Postoperative pain syndrome occurs in two groups; however, the RF group experiences higher intensity and longer duration of pain.Conclusion: Radiofrequency ablation and argon plasma coagulation are effective and safe treatments for rectal bleeding in chronic radiation proctitis without erosive or ulcerative lesions.

P-203 Pathological evaluation of the therapeutic effect of argon plasma coagulation in gastric low grade dysplasia

P-203 Pathological evaluation of the therapeutic effect of argon plasma coagulation in gastric low grade dysplasia

Comparison of Endoscopic Radiofrequency Ablation and Argon Plasma Coagulation in Patients with Gastric Low-Grade Intraepithelial Neoplasia: A Large-Scale Retrospective Study.

Background Gastric low-grade intraepithelial neoplasia (LGIN) is a precancerous lesion of gastric cancer. Endoscopic therapies represented by radiofrequency ablation (RFA) and argon plasma coagulation (APC) have been applied to treat gastric LGIN in recent years. However, no comparative study examining the effectiveness and safety profiles of RFA and APC has been reported. Methods A single-center, large-scale, retrospective study, including 73 and 50 patients treated with RFA and APC, respectively, was conducted in the First Medical Center of Chinese PLA General Hospital from October 2015 to October 2020, with a two-year follow-up. Effectiveness, complications, operative factors, and other data were assessed. Results At 2 years of follow-up, cure, relapse, recurrence, and progression rates were 90.4%, 9.6%, 9.6%, and 2.7% in the RFA group, respectively, versus 90%, 10%, 12%, and 4% in the APC group, respectively, with no statistically significant differences between the two groups (all p > 0.05). However, the mean lesion size was significantly larger in the RFA group (2.6 ± 1.0 cm) than in the APC group (1.5 ± 0.6 cm) (p < 0.001); there was also a significant difference in the composition ratio of large lesions between the two groups (p < 0.001). No serious postoperative complications showed in either group, and the abdominal pain was the most common symptom in the short term after surgery. Conclusions RFA and APC are both safe and effective destructive therapies for gastric LGIN. RFA is more suitable for flat and large lesions, while APC is more suitable for small lesions, especially those with slight local uplift or depression. An intraoperative submucosal injection is expected to be an effective method for relieving postoperative abdominal pain.

Intraoperative argon-plasma coagulation treatment for patients with malignant pleural mesothelioma.

Malignant pleural mesothelioma (MPM) is often associated with asbestos exposure and carries an extremely poor prognosis. The present study assessed the effectiveness of argon plasma coagulation (APC) treatment in patients with MPM who underwent radical pleural decortication (PD). The clinical data from 11 patients who underwent radical PD treated with APC at Toho University Omori Medical Center from July 2015 to March 2020 were retrospectively analyzed. Clinical features, local recurrence, and clinical prognoses were evaluated. The median overall survival was 18.5 months, and the 1- and 2-year overall survival rates were 71.6 and 43.0%, respectively. One patient survived 5 years but had recurrent tumors. The median disease-free survival was 11.1 months. The 1- and 2-year disease-free survival rates were 49.9 and 12.5%, respectively. Three patients had no recurrences, two of whom were followed continuously (39.6 and 10.2 months). The present study revealed that APC treatment for MPM might be associated with good survival and prognosis. APC as an additional intraoperative treatment for patients with MPM may be further investigated with larger multi-center clinical trials to support its efficacy.

Argon Plasma Coagulation (APC) for the Treatment of Excessive Dynamic Airway Collapse (EDAC): An Animal Pilot Study.

Surgical stabilization of the airway through tracheobronchoplasty (TBP) is the current treatment modality for patients with severe symptomatic excessive dynamic airway collapse. However, TBP is associated with increased morbidity and mortality. Bronchoscopic treatment of the posterior membrane using argon plasma coagulation (APC) may be a safer alternative to TBP in highly selected patients. This study aimed to evaluate the effect of APC in the tracheobronchial tree of a sheep animal model. Two adult sheep were used for this study. Under flexible bronchoscopy, the posterior tracheal membrane was treated with precise APC using different power settings. Chest computed tomography was done at 2 days and bronchoscopy was performed at 30 days following initial procedure, before euthanasia. The airways were assessed for the presence of treatment-related histopathologic changes along with expression of genes associated with fibrosis. There was no perioperative or postoperative morbidity or mortality. Chest computed tomography showed no signs of pneumomediastinum or pneumothorax. Flexible bronchoscopy showed adequate tracheobronchial tissue healing process, independent of the power settings used. Histologic changes demonstrated an increased extent of fibroblastic collagen deposition in the treated posterior membrane when higher power settings were used. In a similar manner, APC treatment managed to activate fibrosis-associated gene transcription factors, with higher settings achieving a higher level of expression. APC at high-power settings achieved higher levels of fibroblast collagen deposition at the posterior membrane and higher expression of fibrosis-associated gene transcription factors, when compared with lower settings.

Argon plasma coagulation-an effective treatment for solitary rectal ulcer syndrome: Asingle-center experience from western India.

Solitary rectal ulcer syndrome (SRUS) is an uncommon benign disorder of defecation. Management of ulcers is usually unsatisfactory with conventional treatment (laxatives, behavioral therapy, biofeedback, topical treatments, and surgery). Studies on the effectiveness of argon plasma coagulation (APC) for SRUS refractory to conventional treatment is lacking. The aim of the study was to examine the effect of APC with conventional therapy in controlling bleeding and healing of refractory SRUS. Fourteen patients of refractory SRUS diagnosed on clinical, colonoscopic, and histological findings, refractory to conventional therapy, were offered multiple sessions of APC in addition to conventional treatment. All patients were followed up to determine bleeding control and ulcer healing. Fourteen patients with a mean duration of symptoms of 9.21 ± 6.94months were included. All thepatients were advised to have a high intake of fluids and laxatives and to undergo biofeedback in addition to the APC. Lesions were located anteriorly (66%), circumferentially (25%), and posteriorly (9%). Mean follow-up durationwas 7months (3 to 12months). APC enabled bleeding control in all thepatients (100%), complete healing of ulcer in 71% (10 patients), and reduction in ulcer size to less than 50% of the initial size in the remaining 29% patients. None of the patients had any procedure-related complications like bowel perforation, infections, or fistula formation. APC with conventional therapy is effective in controlling bleeding and healing in SRUS refractory to conventional treatment.

Argon plasma coagulation for superficial squamous cell carcinoma in the residual esophagus after esophagectomy.

Patients after esophagectomy for esophageal squamous cell carcinoma (SCC) occasionally develop metachronous SCC in the residual esophagus. Although most of these second primary lesions are detected as superficial cancer at follow-up endoscopy, it is often difficult to perform endoscopic resection for these lesions near the site of anastomosis. The objective of this study was to evaluate the effectiveness of argon plasma coagulation (APC) for superficial SCC in the residual esophagus after esophagectomy. Twelve patients (involving 15s primary lesions) received APC for superficial SCC in the residual esophagus after esophagectomy. These lesions were difficult to perform endoscopic resection and they were treated using APC. There was no treatment-related complication. Complete remission (CR) was achieved in 13 (86.6%) of the 15 lesions: CR was achieved in 11 lesions (73.3%) after the first APC course, and in another 2 lesions (13.3%) after two or more APC courses. Of the 2 patients with persisting residual tumor, 1 patient received 12 times repeated-APC courses over 6years, and eventually achieved local control without metastasis, the other patient received radiotherapy and cervical esophagectomy after treatment failure with APC. All patients survived except for one patient who died of old age and another patient who died of tongue cancer. APC was a safe treatment that was easy to perform. APC was concluded to be an effective treatment for superficial SCC in the residual esophagus after esophagectomy when endoscopic resection was difficult.

Argon plasma coagulation alone versus argon plasma coagulation plus full-thickness endoscopic suturing to treat weight regain after Roux-en-Y gastric bypass: a prospective randomized trial (with videos)

A significant number of patients regain weight after Roux-en-Y gastric bypass. Ablation with argon plasma coagulation (APC) plus endoscopic full-thickness suturing (FTS-APC) and ablation alone have been reported for treating weight regain when associated with gastrojejunostomy (GJ) dilation. However, comparative controlled data are still lacking. This was a pilot single-center open-label randomized trial comparing the effectiveness and safety of APC alone versus FTS-APC for transoral outlet reduction. Patients with at least 20% weight regain from the nadir, and GJ≥15mm were considered eligible. The primary outcome was percentage total weight loss (%TWL) at 12 months. Secondary outcomes were the incidence of adverse events, amelioration of metabolic laboratory parameters, and improvement in quality of life and eating behavior. Forty patients meeting the eligibility criteria were enrolled from October 2017 to July 2018. Technical and clinical success rates were similar between the groups. At 12 months, the mean %TWL was 8.3% ± 5.5% in the APC alone group versus 7.5% ± 7.7% in the FTS-APC group (P= .71). The pre-revisional % solid gastric retention at 1 hour positively correlated with the probability of achieving≥10% TWL at 12 months. Both groups experienced significant reductions in low-density lipoprotein and triglyceride levels at 12 months, and improvement in eating behavior and quality of life at 3 months. There were 2 cases of stenoses (1 from each group), which were successfully treated with endoscopic balloon dilation. APC alone is similar to FTS-APC in terms of technical and clinical outcomes within 1 year of follow-up. (Clinical trial registration number: NCT03094936.).

A study of the effect of argon plasma coagulation followed by endoscopic band ligation in comparison to endoscopic band ligation alone for the treatment of bleeding gastric antral vascular ectasia in cirrhotic patients

A study of the effect of argon plasma coagulation followed by endoscopic band ligation in comparison to endoscopic band ligation alone for the treatment of bleeding gastric antral vascular ectasia in cirrhotic patients

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

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)

Efficacy of Utilizing Argon Plasma Coagulation for Weight Regain in Roux-en-Y Gastric Bypass Patients: a Multi-center Study.

Endoscopic approaches exist for targeting weight regain after Roux-en-Y gastric bypass (RYGB), including endoscopic suturing, clipping, and sclerotherapy. Argon plasma coagulation (APC) is a noncontact electrocoagulation method, and when used in RYGB patients, it has shown reduction in the diameter of the gastrojejunal anastomosis. To study the effectiveness of APC for weight regain in terms of weight loss for RYGB patients, from eight bariatric centers. A retrospective chart review was performed for 558 patients at eight bariatric centers in the USA (1) and Brazil (7) who underwent APC procedure between 31st July 2009 and 29th March 2017. APC was performed on patients who regained weight after RYGB procedure. Upon exploratory analysis of the individual BMI data, the mean BMI decreased slightly during the first 24months and increased slightly afterwards following the APC intervention. The mean weight was 94.5 ± 18.6kg and the mean BMI was 34.0kg/m2 at APC. Where data were available, the mean of lowest weight was 67.0 ± 23.0kg and the mean of lowest BMI was 24.1kg/m2 following gastric bypass. The mean weight loss was 6.5, 7.7, and 8.3kg at 6, 12, and 24months, respectively, and the changes in weight over time was statistically significant (p < 0.0001). Multi-level for change model showed the low body mass index (BMI) group (BMI < 30kg/m2) to have greater TWL than the high BMI (BMI ≥30kg/m2) group at 6, 12, and 24months. In the low BMI group, the mean TWL was 4.7, 6.1, 6.9, and 2.4%, at 6, 12, and 24months, respectively. In the high BMI group, the mean TWL was 7.5, 10.4, 13.4, and 3.7%, at 6, 12, 24, and 36months, respectively. Of the 333 patients in four centers who provided complication information, complications after APC included stenosis (n = 9), GJ ulcer (n = 3), vomiting (n = 3), GJ leakage (n = 2), and melena (n = 1). APC can be useful in reducing the regained weight after RYGB, and patients showed 6-10% total weight loss at 12months. Randomized trials would be needed to validate the findings.

Long exposure of argon plasma coagulation induces more thermal damage accompanied by a higher expression of NF-κB and caspase-3

Objective: Long exposure of argon plasma coagulation (APC) causes thermal damage and apoptosis in tissues. However, whether the APC-induced thermal damage in tissues involves the expression of NF-κB and caspase-3 remains undetermined. In this study, we compared the effect of APC on liver damage at two different exposure time and tested the hypothesis that thermal injuries induced by APC are accompanied by induction of NF-κB and caspase-3 expression in rat liver.Material and Methods: Liver injuries were induced in rats by an APC device with pulse mode for 2 or 4 seconds under the same frequency of power (40W). The animals were sacrificed 0, 3, 7 and 21 days after injury and the liver tissues were harvested and used for western blotting, histological and immunohistochemical analyses.Results: Haematoxylin and eosin (H&amp;E) stained sections of the liver tissues showed that two-second application of APC caused minimum thermal damage and apoptotic areas, less carbonization, and more fibrosis formation in liver than the four-second APC application at all time points examined. All of these APC-induced thermal effects and morphological changes in the two-second APC application group but not the four-second APC application group recovered 21 days after the treatment. Western blot results indicated that APC induced the expression of NF-κB on day 3, and peaked on days and 14. In the two-second APC application group, the expression of NF-κB returned to the normal level on day 28. However, the expression of NF-κB induced by 4 seconds of APC application remained high even 28 days after injury. The expression of caspase-3 induced by the 2 seconds or 4 seconds of APC application peaked at 7 or 14 days, respectively. Similarly, the APC-induce expression of caspase-3 returned to the normal level in the 2-second APC application group, but it still remained high in the 4-second APC application group even 28 days after injury. These results were further confirmed by The immunofluorescence data also indicated that APC exposure for 4 seconds induced a much higher expression of NF-κB than APC exposure for 2 seconds. The similar pattern was observed in the caspase-3 expression.Conclusions: Taken together, our results show that 2-second APC exposure causes minimum liver injury accompanied by the expressions of NF-κB and casapase-3 which return to the normal level 28 days after injury. These findings strongly suggest that the shortest pulse mode (2 seconds) application of APC is a safe, convenient, and effective approach for the treatment of particularly thermosensitive tissues.

The macroscopic and histological effects of argon plasma coagulation followed by subepithelial ablation on early esophageal squamous cell carcinoma using magnifying endoscopy with blue laser imaging

The macroscopic and histological effects of argon plasma coagulation followed by subepithelial ablation on early esophageal squamous cell carcinoma using magnifying endoscopy with blue laser imaging

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

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.

Evaluation of argon plasma coagulation in healing of a solitary rectal ulcer in comparison with conventional therapy: a randomised controlled trial.

IntroductionArgon plasma coagulation (APC) has been reported to be effective in the treatment of solitary rectal ulcer syndrome (SRUS). However, it has not appeared to be effective in healing ulcers.AimThis study aimed at assessing the effectiveness of APC in controlling rectal ulcer-induced bleeding, and at examining the ultimate effect of this approach in healing these lesions.Material and methodsThis randomised, controlled trial was conducted on 99 patients with SRUS. Patients were randomly enrolled into two groups of APC therapy (intervention) and conventional therapy (control). The control group (n = 58) received a high-fibre diet, laxatives, behaviour therapy, and sucralfate enemas, and the intervention group (n = 41) were treated with APC plus conventional therapy; in fact they received directed and focused argon gas in addition to a high-fibre diet and laxatives.ResultsResponses to treatment in the control group and in the APC-receiving group were 29.3% and 75.6%, respectively. The continuation of ulcer healing after 3 months in the control group was 10.3%, and it was 70.7% in the APC-treated group. There was a significant statistical difference between the two groups (p < 0.004), i.e. bleeding was controlled more frequently in the group receiving APC plus conventional therapies than in the group receiving only the conventional therapies. However, the results showed no statistically significant difference between the two groups in terms of pain relief (p < 0.36).ConclusionsArgon plasma coagulation not only controlled bleeding in patients with SRUS, but also, in comparison with the conventional methods of treating SRUS, led to healing and continuation of healing of rectal ulcers.

Evaluation of combined argon plasma coagulation and savary bougienage for the relief of dysphagia of esophageal squamous cancer patients in the end of life.

214 Background: To relieve the dysphagia is a critical treatment for advanced esophageal cancer patients’ palliative care in their end-of-life. The ideal way is to satisfy both the patient’s nutrition supplement and self-taste. Although several endoscopic dilation techniques have been reported, the high incidence of dysphagia quickly relapsing remains. The aim of this study was to compare the effect of Argon Plasma Coagulation (APC) combined with Savary bougienage (SB) and SB alone for the relief of dysphagia of esophageal squamous cancer in the end-of-life. Methods: Patients with dysphagia for local advanced esophageal squamous cell carcinoma or local tumor recurrence and no any radiotherapy or surgery chance were randomly assigned to undergo APC combined with SB or SB alone. Primary endpoints were the dysphagia-free survival (DFS, be defined as the time from first dilation of effectively relieved dysphagia to dysphagia relapse, days) after 3 months followed up. Results: A total of 60 patients from Cancer Institute, First Affiliated Hospital of Henan University of Science and Technology were included in the study (SB group, n = 30, Combination group [APC combined with SB], n = 30), 2011. October 1-31, 2015. Primary endpoints: 3 months after treatment, DFS of Combination group (30.63 days; 95% CI, 20.31-36.95) was significantly longer than the SB alone group (5.3 days; 95% CI, 3.01-8.84, P = 0.000). No severe complications occurred within both of two groups. Conclusions: APC combined with SB was a safe and well-tolerated method for relieving dysphagia of advanced esophageal squamous cell cancer patients in the end-of-life, more investigation should pay on if this dilation method could obviously improve the life quality of patients and family by questionnaire as well. Clinical trial information: ChiCTR-TRC-13003757.