The role of argon plasma coagulation in the management of Barrett's esophagus: a single-center experience

Abstract

Background: Patients with Barrett's esophagus (BE) are 30 times more likely to develop esophageal adenocarcinoma (EAC) than the general population. Data regarding the use of argon plasma coagulation (APC) for treatment of patients with BE in Egypt are still limited. This work was to study the efficacy and safety of APC as an ablative modality in Egyptian patients with BE. Methods: A total of 73 referred eligible patients with a confirmed endoscopic and histopathologic diagnosis of BE were enrolled in this study and subjected to thermoablation by hp-APC equipment at 60 W setting, until complete ablation or a maximum of 5 sessions and followed up clinically and endoscopically at 3-month intervals. Results: Compared with a control group (n = 75), there were no significant statistical differences between the two groups regarding the demographic and the base-line clinical data. Minor and major complications occurred in 8/73 (10.95%) and 1/73 (1.36%) of patients respectively. Macroscopic ablation was achieved after one session in 37/73 (50.63%) patients and complete histologic ablation was confirmed after 167 sessions in 69/73 (94.52%). On one-year follow-up, no either relapses of BE or progression to EAC, were observed in patients who have shown complete thermo-ablation. Conclusions: our data revealed that hp-APC at medium-energy setting 60 W, in an acid-reduced environment, could have ablated BE effectively and safely with promising initial results. Surveillance endoscopy is still advocated in such patients.