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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Hybrid argon plasma coagulation for the treatment of Barrett’s esophagus: A prospective, multicenter study
Dong Wang, Yan Chen, Feng Ji, Jian-Wei Hu, Ping-Hong Zhou, Shu-Chang Xu, Ying Chen, Li-Ping Ye, Guo-Liang Ye, Rui Li, Zhao-Shen Li
Dong Wang, Department of Gastroenterology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
Yan Chen, Zhao-Shen Li, Department of Gastroenterology, Changhai Hospital, Shanghai 200438, China
Feng Ji, Department of Gastroenterology, The First Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 311399, Zhejiang Province, China
Jian-Wei Hu, Ping-Hong Zhou, Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Shu-Chang Xu, Ying Chen, Endoscopy Center, Tongji Hospital of Tongji University, Shanghai 200092, China
Li-Ping Ye, Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, Taizhou 318001, Zhejiang Province, China
Guo-Liang Ye, Department of Gastroenterology, The Affiliated Hospital of Medicine School, Ningbo University, Ningbo 315021, Zhejiang Province, China
Rui Li, Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
Co-first authors: Dong Wang and Yan Chen.
Author contributions: Li ZS, Wang D designed the research study; Li ZS, Wang D, Yan Chen, Ji F, Hu JW, Zhou PH, Xu SC, Ying Chen, Ye LP, Ye GL, and Li R performed the research; Li ZS, Wang D and Yan Chen analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Changhai Hospital Institutional Review Board, No. CHEC2017-221.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Zhao-Shen Li, Doctor, PhD, Professor, Department of Gastroenterology, Changhai Hospital, No. 168 Changhai Road, Yangpu District, Shanghai 200433, China.
changhailzs@126.com
Received: January 17, 2024
Revised: May 9, 2024
Accepted: May 20, 2024
Published online: July 6, 2024
Processing time: 164 Days and 2.6 Hours
BACKGROUND
The incidence of Barrett’s esophagus (BE) in China is lower compared to the Western populations. Hence, studies conducted in the Chinese population has been limited. The current treatment options available for BE treatment includes argon plasma coagulation (APC), radiofrequency ablation and cryoablation, all with varying degrees of success.
AIM
To determine the efficacy and safety of HybridAPC in the treatment of BE.
METHODS
The study cohort consisted of patients with BE who underwent HybridAPC ablation treatment. These procedures were performed by seven endoscopists from different tertiary hospitals. The duration of the procedure, curative rate, complications and recurrent rate by 1-year follow-up were recorded.
RESULTS
Eighty individuals were enrolled for treatment from July 2017 to June 2020, comprising of 39 males and 41 females with a median age of 54 years (range, 30 to 83 years). The technical success rate of HybridAPC was 100% and the overall curative rate was 98.15%. No severe complications occurred during the operation. BE cases were classified as short-segment BE and long-segment BE. Patients with short-segment BE were all considered cured without complications. Thirty-six patients completed the one-year follow-up without recurrence. Twenty-four percent had mild dysplasia which were all resolved with one post-procedural treatment. The mean duration of the procedure was 10.94 ± 6.52 min.
CONCLUSION
Treatment of BE with HybridAPC was found to be a simple and quick procedure that is safe and effective during the short-term follow-up, especially in cases of short-segment BE. This technique could be considered as a feasible alternative ablation therapy for BE.
Core Tip: Among the ablation therapies, radiofrequency ablation (RFA) and Argon plasma coagulation (APC) have been the preferred method. However, there is no method that can 100% complete ablation success. Cryotherapy has become a rescue technique for patients with failed RFA. Meanwhile, the techniques used and resulting success rates have been variable. Hybrid APC technology combines injection and APC ablation technology, which may become an easier to use alternative method and may be used more widely. A prospective, multicenter study was undertaken to assess the feasibility and safety of ablation treatment, using HybridAPC, in the treatment of Barrett’s esophagus patients in China.
