Hybrid Argon Plasma Coagulation in the ablation treatment of Barrett´s esophagus – 24 months results

DASTYCH, Milan, Radek KROUPA, Aleš HEP, Štefan KONEČNÝ, Lumír KUNOVSKÝ and Jiří DOLINA. Hybrid Argon Plasma Coagulation in the ablation treatment of Barrett´s esophagus – 24 months results. In GASTRO 2021 Prague. 2021.

Basic information

• Original name: Hybrid Argon Plasma Coagulation in the ablation treatment of Barrett´s esophagus – 24 months results
• Authors: DASTYCH, Milan, Radek KROUPA, Aleš HEP, Štefan KONEČNÝ, Lumír KUNOVSKÝ and Jiří DOLINA.
• Edition: GASTRO 2021 Prague, 2021.

Other information

• Type of outcome: Conference abstract
• Confidentiality degree: is not subject to a state or trade secret
• Keywords in English: Barrett´s esophagus; Endoscopy; Ablation; Endoscopic resection; Argon plasma coagulation

Abstract

Aims: As an alternative to radiofrequency ablation (RFA), combined use of argon plasma coagulation with prior submucosal injection (hybrid APC) had been used successfully for ablation of dysplastic or residual intestinal metaplasia (IM) in Barrett´s esophagus (BE). Our study aims to analyze 24 months follow up results of hybrid APC in BE. Methods: Single center study included patients with BE with dysplasia either without visible lesion or with visible lesion after prior endoscopic resection for ablation of residual BE. The extent of BE was limited to maximal 5 cm length. Hybrid APC (ERBE) was done during sedated endoscopy up to 3 sessions in 2-3 months intervals. Follow up by endoscopy with biopsy was regularly performed in 6 months intervals. Results: From 25 included patients, 20 patients (mean age 60 years, 80 % male) were available for analysis 2 years after intervention. In 5 (25 %) patients previous endoscopic resection of visible lesion with dysplasia or early cancer was done. Mean 1.5 hybrid APC procedures were performed per patient to get optimal endoscopic result. In 24 months, histologic absence of dysplasia was achieved in 19/20 (95 %). Endoscopic and histologic absence of IM was achieved in 18/20 (90 %) and 15/20 (75 %) respectively. In 4 patients nonvisible IM was detected by biopsy, while a small visible abnormality without confirmed IM was seen in 2 patients. The main procedure related symptoms were pain and dysphagia in 60 % and 15 % respectively. Stricture developed in 1/20 (5 %). No perforation or bleeding occurred. Conclusion: Hybrid APC seems an effective, safe and easy method in the ablation of short segment BE either in nonvisible dysplasia or residual IM after endoscopic resection. However, repetitive procedures and follow up are required