Endoscopic treatment of benign gastrointestinal anastomotic strictures using argon plasma coagulation in combination with diathermy

Abstract

Endoscopic argon plasma coagulation in combination with diathermy is a safe and effective technique for the treatment of short postsurgical gastrointestinal anastomotic strictures.

Evaluation of Combined Argon Plasma Coagulation and Savary Bougienage for the Relief of Anastomotic-Stenosis after Esophageal Squamous Cancer Surgery

“…This method is a form of non-contact electrocoagulation, and one of the advantages of APC is the outstanding long-term efficacy [24,25]. In our study, the efficiency of the APC group was clearly better than that of the SB group after one month (ER: 80 vs. 20%) and three months (ER: 20 vs. 3.3%).…”

“…In our study, the efficiency of the APC group was clearly better than that of the SB group after one month (ER: 80 vs. 20%) and three months (ER: 20 vs. 3.3%). In addition, another attractive characteristic of APC is easy to practice for endoscopists and the process of APC performed is only 10-15 min [24,25], which is considerably more rapid than laser therapy and microwave tissue coagulation [20,28]. APC is clearly more ideal as it shortens the operating time for endoscopists and also reduces patient discomfort in the procedure.…”

“…APC is clearly more ideal as it shortens the operating time for endoscopists and also reduces patient discomfort in the procedure. APC is a safer method for treating anastomotic-stenosis patients and serious complications, such as perforation and/or fistula to the respiratory tract, are rarely reported according to previous studies [24,25]. …”

“…It is noteworthy that the combination of the multiple techniques was able to show improvement in outcome with respect to the relapse rate for dysphagia. For example, the dilation therapy of electrocautery incision in combination with Savary bougienage, and APC with diathermy are superior in prolonging the dysphagia-free period and decreasing the need for re-treatment [23,24,25]. It is unclear if APC combined with SB on postoperative anastomotic-stenosis after esophageal resection would be superior to other techniques, which is the objective of this study.…”

The role of upper gastrointestinal endoscopy in treating postoperative complications in bariatric surgery

“…Schubert et al used argon plasma coagulation combined with diathermy to treat 49 patients with anastomotic strictures. 52 They used electroincision to create flaps and then argon plasma coagulation to reduce the size of the flaps, which resulted in dilatation of the gastrointestinal lumen at the location of the stricture. Although this was not specifically preformed for anastomotic strictures following RYGB, they reported that 92% of patients required only one treatment session to gain long-term recanalization.…”