[Argon plasma coagulation through a flexible endoscope. Evaluation of a new therapeutic method after 1606 uses]

Argon plasma coagulation (APC) through a flexible endoscope provides a new technique for thermal devitalization or blood coagulation which is gaining wider attention. This study was undertaken to test clinically the efficacy, safety and ergonomics of the method.

697 consecutive patients (386 men, 311 women; mean age 67 years [3 months--97 years]) had undergone the procedure in 1606 sitting since 1991. Applications included various forms and causes of bleeding in the upper or lower gastrointestinal tract or bronchial system, malignant and benign tumours, ingrowth of tissues and over-growth in stents, fistulas and, since 1993, angiodysplasias and other dysplasias.

The precisely defined therapeutic aim was achieved in nearly all cases during an average of 2.3 sittings per patient, while it failed in 1.5%. Perforations occurred in 5 (0.31%), ending fatally in one. Intestinal wall emphysema was diagnosed in 8 cases (0.5%), all remaining symptom-free. During a mean follow-up period of 23 (1-72) months there were no other serious immediate or late complications or side effects ascribable to the procedure.

APC is a new efficacious, repeatable, safe and easily learned method for devitalization of tissues and for achieving haemostasis, especially for bleeding from surfaces. Similar applications are being developed in other specialties.