Original ArticlesThe tissue effect of argon plasma coagulation on esophageal and gastric mucosa☆,☆☆
Section snippets
Patients and methods
Samples of normal esophageal and gastric tissue were obtained from patients with esophageal or gastric cancer undergoing surgical resection. The samples of normal tissue were obtained from the margins of the resection specimens. Two patients with esophageal adenocarcinoma and one with esophageal squamous carcinoma each provided a single sample of normal esophageal tissue and three with gastric adenocarcinoma each provided a single sample of normal gastric tissue. The median age of the patients
Results
The macroscopic appearance of the tissue damage produced is shown in Figure 1.The histologic effect consisted of coagulation necrosis that varied from superficial cell damage to wedge-shaped defects. This was associated with coagulation of the stroma in the mucosa and deeper within the submucosa. Submucosal blood vessels did not appear to be affected.
Discussion
The results of this tissue study suggest that deep tissue destruction that could lead to perforation is rare with EAPC. This would support data from clinical reports that perforation occurs only occasionally: Johanns et al.7 report 2 cases of gas in the mediastinum and peritoneal cavity after EAPC, and one case of accumulation of submucosal gas in the cecum out of 66 patients studied. In all three cases these effects were transitory, caused no symptoms, and resolved spontaneously. Grund et al.8
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Reprint requests: K. Matthewson, MD, Consultant Gastroenterologist, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, United Kingdom.
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Gastrointest Endosc 2000;52:342–5.