Argon plasma coagulation (APC) in gastroenterology: Experimental and clinical experiences
Argon plasma coagulation (APC) in gastroenterology: Experimental and clinical experiences
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DOI：
10.1097/00042737-199706000-00006
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发表时间：
1997-06-01
影响因子：
2.1
通讯作者：
Greiner, L
中科院分区：
文献类型：
--
作者：
Johanns, W;Luis, W;Greiner, L
背景：透热疗法在介入性内镜检查中是必不可少的。氩束凝固是一种创新的无接触电凝技术，其中高频交流电被输送到组织通过电离氩gas.Methods和patients：在临床应用之前，我们进行了体外研究，调查的深度和直径组织凝固新鲜手术标本从胃，小肠和结肠。使用了5种不同的功率/气体流量设置（40 - 155 W，2 - 7 l/min）。冲击时间（1- 10秒）和探头的入射角（45度和90度）也不同。坏死最深2.4mm，最大直径1.1cm。即使在结肠和十二指肠等关键部位也未发生穿孔。因此，我们在66例连续患者中进行了氩束凝固。分别使用40和70 W以及2和3 l/min的两种功率/气体流量设置。的影响时间和入射角是不同的individual.Results：在49的50例渗出出血的血管发育不良病变，息肉切除部位，糜烂或溃疡或渗出的血液，由于血管穿透肿瘤，最终止血是在一至两个会议。在所有11例残留无蒂腺瘤组织的患者中，完全切除是可能的。所有5例狭窄性肿瘤患者的食管通畅性均得到恢复。在一例盲肠极血管发育不良的患者中，观察到粘膜下层无症状的气体积聚，并自发消退。在两个广泛的食管癌患者中，有一个短暂的-也是无症状的-积累气体在纵隔和腹膜腔，但没有证据perforation.Conclusion：氩等离子体电凝是一种有效的，成本相对较低的替代激光治疗胃肠内窥镜。
Background: Diathermy procedures are indispensable in interventional endoscopy. Argon beam coagulation is an innovative no-touch electrocoagulation technique in which high-frequency alternating current is delivered to the tissue through ionized argon gas.Methods and patients: Before clinical application, we conducted in-vitro studies to investigate the depth and diameter of tissue coagulation in fresh operative specimens from the stomach, small intestine and colon. Five different power/gas flow settings between 40 and 155W and 2 and 7 l/min were used. The impact time (1-10s) and the incident angle of the probe (45 degrees and 90 degrees) were also varied. The maximum depth of necrosis was 2.4 mm, the maximum diameter 1.1 cm. No perforation occurred even in critical areas such as the colon and duodenum. We therefore performed argon beam coagulation in 66 consecutive patients. Two power/gas flow settings of 40 and 70W and 2 and 3 l/min, respectively, were used. The impact time and incident angle were varied individually.Results: In 49 of the 50 patients with oozing haemorrhage from angiodysplastic lesions, polypectomy sites, erosions or ulcers or oozing of blood due to vascular penetration by tumours, definitive haemostasis was achieved in one to two sessions. In all 11 patients with residual sessile adenoma tissue, complete removal was possible. Oesophageal patency was restored in all five patients with stenosing tumours. In one patient with angiodysplasia of the caecal pole, an asymptomatic accumulation of gas in the submucosa was observed which resolved spontaneously. In two patients with extensive oesophageal carcinoma, there was a transitory - also asymptomatic - accumulation of gas in the mediastinum and peritoneal cavity but no evidence of perforation.Conclusion: Argon plasma electrocoagulation is an effective and relatively low-cost alternative to laser therapy in gastrointestinal endoscopy.