Analysis of argon plasma coagulation in treatment of upper digestive tract disease
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Objective To explore the efficacy of argon plasma coagulation(APC) in treatment of upper digestive tract disease under endoscope.Methods 61 patients of upper digestive tract disease were treated by APC.Among 61 patients,26 cases were gastroesophageal polypus,13 cases were gastritis verrucosa,8 cases were Barrett′s esophageal,42 cases were upper gastrointestinal hemorrhage.Results For 26 cases of gastroesophageal polyp,the lesions were eliminated and no residual lesions were found when checked by endoscopy 3 months after APC treatment.For 13 case of gastritis verrucosa,all cases recovered thoroughly when checked by endoscopy 1 month after APC treatment.For 8 cases of Barrett′s esophageal treated with APC accompanied by drugs,2 case relapsed as shown by endoscopy and biopsy 1 year after the treatment.For 14 cases of upper gastrointestinal hemorrhage,no hemorrhage was found after APC treatment.Conclusion APC in treatment of upper digestive tract disease under endoscope has features of safety,effective ness,easy operation and less complications.Keywords:
Endoscope
Digestive tract
Endoscopic treatment
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Barrett's esophagus
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Objective. To estimate a high-frequency welding of the living tissues as a variant of treatment for the Barrett’s esophagus.
Materials and metods. Retrospective analysis of the treatment results was conducted in 73 patients, suffering Barrett’s esophagus, in 36 of whom the argon-plasm coagulation was performed (Group I), while in 37 (Group II) - a high frequency welding of living tissues. Into the investigation the patients with a short-segment Barrett’s esophagus C2-3M3-4 (the Prague Classification, 2004 yr) and a high-grade dysplasia without a nodule development (VI World Congress of International Society for Diseases of the Esophagus (ISDE) were included.
Results. In patients of Group I a severe esophageal edema have occurred in accordance to endoscopic ultrasonography data. In this Group in 5 (13.89%) patients after performance of the argon-plasm coagulation esophageal stenosis was observed, corrected by application of the balloon dilation. In 8 (22.22%) patients of this Group the disease recurrence have occurred, necessitating performance of additional séance of the argon-plasm coagulation. In patients of Group II the above mentioned inflammatory signs were less pronounced, and mucosal regeneration have proceeded more rapidly, than in patients of Group I - during 53 and 115 days, accordingly. The disease recurrence was noted in 2 (5.41%) patients of Group II only.
Conclusion. High-frequency welding of living tissues constitute a safe and effective method of treatment in patients, having esophageal metaplasia.
Metaplasia
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Gastric Polyp
Hyperplastic Polyp
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Objective:To investigate the endoscopic features of upper gastrointestinal mucosa lesions of uremic patients and to analyse the relationship among mucosa lesions,clinical symptoms and dialysis.Methods:The clinical data of 46 cases of uremic patients with upper gastrointestinal symptoms accepted gastroscopy from December 2004 to December 2007 were analysed retrospectively.Results:All patients had different degrees of upper gastrointestinal mucosa changes.The major types of mucosa lesions were chronic superficial gastritis(52.2%),erosive gastritis(23.9%),peptic ulcer(15.2%),and so on.The incidence of erosive gastritis in dialysis group was higher than conservative therapy group(P0.05).Other performance in gastroscopy had no significant difference between the two groups.Conclusion:The incidence of upper gastrointestinal mucosa lesions of uremic patients was high,and the dialysis treatment has no significant effect to the upper gastrointestinal mucosa lesions.
Peptic
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Objective To evaluate the clinical value and safety of argon plasma coagulation(APC) in the endoscopic treatment of intestinal precancerous lesion—intestinal polyps and adenoma.Methods From April 2004 to December 2007,17 outpatient cases with intestinal polyps and adenoma were examined under endoscopy and histopathology.They were treated by using APC under endoscopy.All cases were rechecked by endoscopy and histopathology after 6 months.Results Sixteen patients(94%) were disappeared in clinical symptoms.The endoscopic and histopathologic recheck shewed that the lesion area healed and had been covered by normal mucosa.The adenoma was remitted in clinical symptoms and reduced obviously in 1 patient(6%) who was treated again by APC.Conclusion APC is an alternative,non-touched technique via endoscopy and new method in the treatment of intestinal precancerous lesion.It can make the treatment simple, safe and effective.
Histopathology
Precancerous lesion
Intestinal mucosa
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[Objective] To assess the efficacy of argon plasma coagulation (APC) in the treatment of mature verrucosa gastritis. [Methods] 35 patients with mature verrucosa gastritis diagnosed by endoscopy and biopsy underwent APC therapy. Argon flow rate was 2 L/min and APC power ranged from 40 W to 60 W. After APC treatment, all patients received omeprazole therapy for two weeks. Clinical follow-up and another endoscopic examination were performed one month later. [Results] 146 verrucous lesions in 35 patients were ablated through APC therapy. Ablating frequency depended on the extent of lesions and the average time of treatment was 3.9 s (2~6 s). None of complications including bleeding or perforation happened. At the one month follow up, 31 patients (88.6%) had no symptom and endoscopic examination indicated that verrucous lesions became flatten and mucosal inflammation improved markedly. 4 patients (11.4%) still had digestive symptoms and endoscopic examination show slight or moderate improvement. [Conclusions] APC therapy is an effective and safe method for mature verrucosa gastritis.
Perforation
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An 11‐year‐old spayed female miniature dachshund was evaluated for a 2‐month history of chronic vomiting. Abdominal ultrasonography revealed a heterogeneous mass in the pyloric region. Contrast upper gastrointestinal radiography demonstrated impairment of gastric outflow. Endoscopic examination revealed multiple polyps at the gastric pylorus. The pyloric polyps were variable in size, sessile‐shaped and pedunculated. Initially, endoscopic polypectomy was attempted, but all the polyps could not be completely resected. Thus, endoscopic polypectomy with argon plasma coagulation was performed to cauterise the lesions. The histopathological diagnosis of the lesions was inflammatory polyps, and a moderate number of Helicobacter spp. was revealed. After the argon plasma coagulation treatment, the dog did not vomit, and improvement of clinical signs was maintained for 13 months. Endoscopic polypectomy with argon plasma coagulation may be useful for mixtures of sessile and pedunculated polyps. The present report may provide a basis for further studies of argon plasma coagulation treatment for canine gastrointestinal polyps.
Polypectomy
Gastric Polyp
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Transplant surgery
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BACKGROUND: Gastric antral vascular ectasia is a disorder whose pathogenetic mechanism is unknown. The endoscopic treatment with argon plasma coagulation has been considered one of the best endoscopic therapeutic options. AIM: To analyze the endoscopic and clinical features of gastric antral vascular ectasia and its response to the argon plasma coagulation treatment. PATIENTS AND METHODS: Eighteen patients were studied and classified into two groups: group 1 - whose endoscopic aspect was striped (watermelon) or of the diffuse confluent type; group 2 - diffuse spotty nonconfluent endoscopic aspect. RESULTS: Group 1 with eight patients, all having autoimmune antibodies, but one, whose antibodies were not searched for. Three were cirrhotic and three had hypothyroidism. All had gastric mucosa atrophy. In group 2, with 10 patients, all had non-immune liver disease, with platelet levels below 90.000. Ten patients were submitted to argon plasma coagulation treatment, with 2 to 36 months of follow-up. Lesions recurred in all patients who remained in the follow-up program and one did not respond to treatment for acute bleeding control. CONCLUSION: There seem to be two distinct groups of patients with gastric antral vascular ectasia: one related to immunologic disorders and other to non-immune chronic liver disease and low platelets. The endoscopic treatment using argon plasma coagulation had a high recurrence in the long-term evaluation.
Endoscopic treatment
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Objective: To observe the values of the endoscopic argon plasma coagulation(APC) in gastrointestinal polyps and verrucose gastritis. Methods:The gastrointestinal polyps and verrucose gastritis were coagulated by ERBE APC 300 made in German. Results: Thirty two patients with gastrointestinal polyps and sixteen patients with vetmcosa gastritis were cured by APC.Conclusion:APC is an effective method in the treatment of gastrointestinal polyps and verrucose gastritis with good effects.
Gastrointestinal bleeding
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