Using argon plasma coagulation in the treatment of Barrett’s esophagus

Aim. To improve the treatment results of patients with Barrett’s esophagus by using videoendosurgical technologies and the application of argon plasma coagulation.

Methods. Treatment results of 16 patients with Barrett’s esophagus who underwent endoscopic argon plasma coagulation of esophageal epithelium metaplasia foci are presented. Endoscopic studies protocols were based on the Prague criteria - the maximum extent of the flames (M) and the maximum extent of the circular segment of Barrett’s esophagus (C). Long segment Barrett’s esophagus prevailed in the majority of patients. Argon plasma coagulation was performed in FORCED mode (power of 30-32 watts with an argon flow of 2-2.2 L/min). For 1 session coagulation of the affected area of no more than 4 cm2 was performed.

Results. In the immediate postoperative period, complications of treatment were not observed. In 12 patients course of treatment with argon plasma coagulation was fully completed, repeated courses were administered depending on the segment length (1 patient required 1 session, 3 patients - 2 sessions, 2 - 3 sessions, 4 patients - 4 sessions, 2 patients - 5 sessions). Manipulation duration was about 5-7 minutes. In these patients, there was complete regression of metaplastic epithelium with its replacement by typical stratified squamous epithelium. 4 patients continue treatment.

Conclusion. Surgical treatment is indicated to all patients with Barrett’s esophagus, in the postoperative period - the use of endoscopic argon plasma coagulation, which should be performed in stages with 1-1.5 month intervals with obligatory endoscopic and histological control.