Efficacy and safety of Hybrid Argon Plasma Coagulation technique in patients with Barrett’s esophagus-related dysplasia: a multicenter italian prospective study initial results

Aims Preliminary data from a prospective, single-arm, multicenter observational study to evaluate the initial treatment success of the Hybrid-APC (H-APC) technique, which combines argon plasma coagulation (APC) with a previous saline injection for ablation therapy of neoplastic Barrett's esophagus (BE).

Methods We prospectively collected data from 24 patients with BE (mean C of 0.64 SD 0,91 and M of 2.28 SD 1,15) who underwent H-APC therapy in 4 Italian hospitals. None of them had previous ablative therapy. Max 5 sessions to reach complete eradication of visible metaplasia and max 50% of the circumference treatment for each session were allowed. After 7 days from each session patients received a phone call to assess pain (0-10, 0=no pain, 10=worst pain) and dysphagia (1-5, 1=No dysphagia 5=unable to swallow anything)

Results 43% of the patients were treated with endoscopic resection for visible lesion (50% PT1a; 50% HGD), while 57% started directly with ablation (81% LGD; 19 % HGD). CE-D and CE-IM were 100% and 100%, respectively after a mean of 1.5 ablation sessions. 67% of patients achieved primary outcome with just one treatment with a mean duration of 26 minutes SD 12.22. One case of temporary dysphagia, which did not require any treatment (4%) was observed without any other major adverse events and good tolerability profile: 93% of patients did not change their daily activities after treatment with a median pain score of 1,35 SD 2,00 and dysphagia score of 1,4 SD 0,74

Conclusions H-APC appears to have high efficacy, safety, and tolerability profile, with a limited number of treatment sessions required to achieve initial CE-IM.

Conflicts of interest

Medtronic consultantLaborie consultant3DMatrix consultantApollo Endosurgery consultantERBE consultantfujiflm consultant

Publication History

Article published online:
14 April 2023