Benefit, tolerance, and safety of hybrid argon plasma coagulation for treatment of Barrett's esophagus: US pilot study

Toshitaka Shimizu; Jason B. Samarasena; Kyle J. Fortinsky; Rintaro Hashimoto; Nabil El Hage Chehade; Matthew A. Chin; Zain Moosvi; Kenneth J. Chang

doi:10.1055/a-1492-2450

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Benefit, tolerance, and safety of hybrid argon plasma coagulation for treatment of Barrett's esophagus: US pilot study

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Benefit, tolerance, and safety of hybrid argon plasma coagulation for treatment of Barrett's esophagus: US pilot study

Toshitaka Shimizu, Jason B. Samarasena, Kyle J. Fortinsky, Rintaro Hashimoto, Nabil El Hage Chehade, Matthew A. Chin, Zain Moosvi and Kenneth J. Chang

Endoscopy International Open, Vol.9(12), pp.E1870-E1876

12/01/2021

DOI: 10.1055/a-1492-2450

PMCID: PMC8671001

PMID: 34917455

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Abstract

Background and study aims A novel technique for Barrett’s esophagus (BE) ablation, termed hybrid APC, has recently been developed. The aims of this US pilot study were to evaluate the efficacy, tolerance and safety of hybrid APC for the treatment of BE. Patients and methods Patients with biopsy-proven BE referred to our tertiary care center over a 12-month period for mucosal ablation were eligible for this study. Efficacy of ablation was measured on follow-up endoscopy by demonstrating either a reduction of visible BE or biopsies proving complete resolution of intestinal metaplasia (CRIM). To evaluate tolerance and safety, patients were called on post-procedure days 1 and 7. Results Twenty-two patients with BE (4.5 % intramucosal carcinoma, 31.8 % high-grade dysplasia, 18.1 % low-grade dysplasia, 36.3 % non-dysplastic, 9.1 % indefinite for dysplasia) underwent 40 treatments with hybrid APC. All patients had endoscopic improvement of BE disease and 19 of 22 patients (86.4 %) achieved CRIM. With regard to tolerance, average pain scores (0 to 10 scale) on follow-up were 2.65 and 0.62 on days 1 and 7, respectively. With regards to safety, there were two treatment-related strictures (9.1 %) that required a single balloon dilation. Conclusions Hybrid APC appears to be promising in the treatment of BE. The ablation protocol used in this study demonstrated efficacy, tolerability, and a safety profile similar to radiofrequency ablation. Given the significant price difference between hybrid APC and other modalities for Barrett’s ablation, this modality may be more cost-effective. These results warrant further study in a large prospective multicenter trial.

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Title: Subtitle: Benefit, tolerance, and safety of hybrid argon plasma coagulation for treatment of Barrett's esophagus: US pilot study
Creators: Toshitaka Shimizu - University of California, Irvine
Jason B. Samarasena - University of California, Irvine
Kyle J. Fortinsky - University of California, Irvine
Rintaro Hashimoto - University of California, Irvine
Nabil El Hage Chehade - University of California, Irvine
Matthew A. Chin - University of California, Irvine
Zain Moosvi - University of California, Irvine
Kenneth J. Chang - University of California, Irvine
Resource Type: Journal article
Publication Details: Endoscopy International Open, Vol.9(12), pp.E1870-E1876
Publisher: Georg Thieme Verlag KG
DOI: 10.1055/a-1492-2450
PMID: 34917455
PMCID: PMC8671001
ISSN: 2364-3722
eISSN: 2196-9736
Language: English
Date published: 12/01/2021
Academic Unit: Internal Medicine
Record Identifier: 9984697050302771

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