ARGON PLASMA COAGULATION THROUGH A FLEXIB LE ENDOSCOPE - EVALUATION OF A NEW THERAPEUTIC METHOD AFTER 1606 APPLICATIONS

Background and objective: Argon plasma coagulation (APC) through a fle xible endoscope provides a new technique for thermal devitalization or blood coagulation which is gaining wider attention. This study was un dertaken to test clinically the efficacy, safety and ergonomics of the method. Patients and methods: 697 consecutive patients (386 men, 311 women; mean age 67 years [3 months-97 years]) had undergone the proced ure in 1606 sittings since 1991. Applications included various forms a nd couses of bleeding in the upper or lower gastrointestinal tract or bronchial system, malignant and benign tumours, ingrowth of tissues an d overgrowth in stents, fistulas and, since 1993, angiodysplasias and other dysplasias. Results: The precisely defined therapeutic aim was a chieved in nearly all cases during an average of 2.3 sittings per pati ent, while it failed in 1.5%. Perforations occurred in 5 (0.31%), endi ng fatally in one. Intestinal wall emphysema was diagnosed in 8 cases (0.5%), all remaining symptom-free. During a mean follow-up period of 23 (1-72) months there were no other serious immediate or late complic ations or side effects ascribable to the procedure. Conclusion: APC is a new efficacious, repeatable, safe and easily learned method for dev italization of tissues and for achieving haemostasis, especially for b leeding from surfaces. Similar applications are being developed in oth er specialities.