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Argon Plasma Coagulation with Submucosal Saline Injection for Gastric Adenoma on Outpatient Basis.

Authors
Lee, KM; Kim, YB; Sin, SJ; Jung, JY; Hwang, JC; Lim, SG; Yoo, BM; Kim, JH; Cho, SW
Citation
Digestive diseases and sciences, 54(12):2623-2628, 2009
Journal Title
Digestive diseases and sciences
ISSN
0163-21161573-2568
Abstract
Gastric adenoma with low-grade dysplasia (LGD) is a less progressive disease than with high-grade dysplasia; nevertheless, a certain portion of lesions can progress. The purpose of this study was to evaluate the effectiveness of argon plasma coagulation (APC) with submucosa saline injections (APC-SSI) for gastric adenoma with LGD on an outpatient department (OPD) basis. We included 57 patients with 64 lesions of gastric adenoma with LGD. Endoscopic type was flat elevated in 58 lesions and central depressed in 6 lesions. Normal saline was injected into the submucosa under the lesion before APC. APC was performed to the lesion and its surrounding mucosa. After treatment, patients underwent regular endoscopy follow-ups. One case each of pneumoperitoneum and Mallory-Weiss tearing occurred and could be managed with conservative care. One case of overt bleeding occurred after 2 weeks and was treated with APC. After 19.5 months of follow-up, four residual adenomas (6.3%) were found and treated with additional APC-SSI. Fourteen metachronous lesions were noted in eight patients (14.0%). Twelve lesions were adenoma with LGD and two lesions were intramucosal adenocarcinoma. APC-SSI is an effective and safe treatment modality for gastric adenoma with LGD on an OPD basis and it is recommended for patients with risk factors of endoscopic mucosal resection (EMR). After treatment of gastric adenoma, meticulous follow-up endoscopy is recommended for detection of metachronous lesions.
DOI
10.1007/s10620-008-0638-7
PMID
19082886
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
Journal Papers > School of Medicine / Graduate School of Medicine > Pathology
AJOU Authors
이기명김영배신성재정재연황재철유병무김진홍조성원
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