The tissue effect of argon plasma coagulation on esophageal and gastric mucosa

Background: Argon plasma coagulation is a diathermy-based non-contact thera peutic endoscopic modality that may have a lower risk of perforation than o ther tissue ablation techniques, Methods: Its effect was studied on three fresh esophageal and three fresh g astric resection specimens using power settings from 40 to 99 Watts at 90 d egrees, with 1 mm separation using pulse durations of 1 and 3 seconds. A sc oring system for depth of tissue damage was created and samples were analyz ed blindly by a gastrointestinal histopathologist, Results: There was significantly greater damage to gastric tissue using a 3 -second (compared with 1-second) pulse (p = 0.003) and marginally significa ntly greater damage to esophageal tissue using the 3-second pulse (p = 0.05 3). Tissue damage was related to power setting for gastric (p = 0.031) but not for esophageal tissue (p = 0.065). Only 1 of 42 esophageal samples and 2 of 42 gastric samples examined showed damage extending into the musculari s propria, Conclusions: Deep tissue damage that could lead to perforation was rare wit h argon plasma coagulation, The depth of gastric mucosal damage increased w ith increased pulse duration and increasing power settings, and, although t he depth of esophageal mucosal damage was marginally related to pulse durat ion, it was not related to the power setting.