Argon plasma coagulation in coloproctology: clinical experience with and prospects for the technique

• Main Authors: E. N. Desyatov, F. Sh. Aliev
• Format: Article
• Language: Russian
• Published: “ABV-press” Publishing house”, LLC 2015-10-01
• Series: Тазовая хирургия и онкология
• Subjects: rectal laterally spreading tumors; mucosa; submucosa; granular laterally spreading tumors; homogeneous granular laterally spreading tumors; endoscopic mucosal resection; endoscopic mucosal resection with submucosal dissection; argon plasma coagulation; transanal excision; transanal endoscopic microsurgery
• Online Access: https://ok.abvpress.ru/jour/article/view/140

Background. Rectal laterally spreading tumors (LSTs) are macroscopically divided into granular (LST-G) and non-granular (LST-NG). LST-Gs have in turn two types: homogeneous and nodular mixed.Subjects and methods. The retrospective study analyzed the data of 20 patients (11 men and 9 women) in whom homogenous LSTs were removed by argon plasma coagulation (APC). The patients» mean age was 65.8 ± 6 years. Therapeutic effectiveness was evaluated by Ki-67 proliferation index and the frequency of complications and recurrences.Results. The average size of removed homogeneous LST-Gs was 12.3 ± 3.8 cm2. The average number of APC sessions to achieve a LST-G reduction was 4.4 ± 0.9. Three days before APC, Ki-67 in the neoplasia biopsy specimens amounted to as much as 67.8 ± 4.4 % on average; it reduced to an average of 33.0 ± 3.0 % at 14 days of APC initiation, 16.5 ± 1.8 and 4.2 ± 0.4 % after 21 and 180 days, respectively.Discussion. Inability to receive complete histological data on removed LST-Gs is a main pitfall in APC.Conclusion. Stepwise tumor APC may be the method of choice in elderly and senile patients with a family history of comorbidity. APC can precisely remove LSTs along the boundary of the dentate line. This technique requires no single-use tools.