Argon Plasma Coagulation in Barrett’s Oesophagus: First Experience from Bangladesh
Rokshana Begum1, Ahmed Lutful Moben2, Sheikh Mohammad Noor E Alam3, Abdur Rahim4, Omar Faruque Sadman5, Md. Abdur Rahman6, Nasif Shahriar7, Nadia Binte Nasir7, Nirupoma Das7, Taslima Akter Lima7, Tasnim Mahmud8, Musarrat Mahtab9, Sheikh Mohammad Fazle Akbar10 and Mamun Al Mahtab11
1Department of Hepatology, Shaheed Suhrawardy Medical College, Dhaka, Bangladesh
2Kurmitola General Hospital, Dhaka, Bangladesh
3Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
4Department of Hepatology, International Medical College, Gazipur, Bangladesh
5Department of Anesthesia, Square Hospital Limited, Dhaka, Bangladesh
6Department of Anesthesia, Analgesia and Intensive Care Medicine, Holy Family Red Crescent Medical College, Dhaka, Bangladesh
7Farabi General Hospital, Dhaka, Bangladesh
8Department of Public Health, North South University, Dhaka, Bangladesh
9Department of Biochemistry, North South University, Dhaka, Bangladesh
10Ehime University, Ehime, Japan, Oita University, Oita, Japan and Miyakawa Memorial Research Foundation, Tokyo, Japan
11Interventional Hepatology Division, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
*Corresponding Author: Mamun Al Mahtab, Interventional Hepatology Division, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Received:
March 06, 2025; Published: March 23, 2025
Abstract
Background: Barrett’s oesophagus is recognized cause of oesophageal carcinoma. Currently different endoscopic treatment modalities are being adopted and evaluated to manage Barrett’s mucosa to prevent subsequent malignant transformation.
Methods: We have recently introduced argon plasma coagulation at endoscopy of upper gastrointestinal tract for Barrett’s oesophagus management in Bangladesh.
Results: The study included 30 Barrett’s oesophagus patients who underwent argon plasma coagulation by a senior Endoscopist. We observed complete eradication of Barrett’s oesophagus in 83.3% cases, while reduction of Barrett’s mucosal length was seen in 90%.
Conclusion: Argon plasma coagulation appears to be safe and effective for Barrett’s oesophagus management. However further work is needed to reach a conclusive statement.
Keywords: Argon Plasma; Coagulation; Barrett’s Oesophagus
References
- Burke ZD and Tosh D. “Barrett’s metaplasia as a paradigm for understanding the development of cancer”. Current Opinion in Genetics and Development 22 (2012): 494-499.
- Wang DH., et al. “Aberrant epithelial-mesenchymal Hedgehog signaling characterizes Barrett’s metaplasia”. Gastroenterology 138 (2010): 1810-1822.
- Lagergren J and Lagergren P. “Recent developments in esophageal adenocarcinoma”. CA: A Cancer Journal for Clinicians 63 (2013): 232-248.
- Runge TM., et al. “Epidemiology of Barrett’s esophagus and esophageal adenocarcinoma”. Gastroenterology Clinics of North America2 (2015): 203.
- Shah SN., et al. “Hybrid argon plasma coagulation in Barrett's esophagus: a systematic review and meta-analysis”. Clinical Endoscopy 1 (2023): 38-49.
- Shaheen NJ., et al. “ACG clinical guideline: diagnosis and management of Barrett’s esophagus”. American Journal of Gastroenterology 111 (2016): 30-50.
- Kolb JM and Wani S. “Endoscopic eradication therapy for Barrett’s oesophagus: state of the art”. Current Opinion in Gastroenterology 36 (2020): 351-358.
- Zagari RM., et al. “Gastro-oesophageal reflux symptoms, oesophagitis and Barrett’s oesophagus in the general population: the Loiano–Monghidoro study”. Gut 10 (2008): 1354-1359.
- Ganz RA., et al. “Complete ablation of esophageal epithelium with a balloon-based bipolar electrode: a phased evaluation in the porcine and in the human esophagus”. Gastrointestinal Endoscopy 60 (2004): 1002-1010.
- Dunkin BJ., et al. “Thin-layer ablation of human esophageal epithelium using a bipolar radiofrequency balloon device”. Surgical Endoscopy 20 (2006): 125-130.
- Sultana S., et al. “Premalignant and malignant esophageal lesions in Bangladeshi patients - a study in a tertiary care hospital”. Central Medical College Journal1 (2023): 20-25.
- van Vilsteren FG., et al. “Stepwise radical endoscopic resection versus radiofrequency ablation for Barrett’s oesophagus with high-grade dysplasia or early cancer: a multicentre randomised trial”. Gut 60 (2011): 765-773.
- Ragunath K., et al. “Endoscopic ablation of dysplastic Barrett's oesophagus comparing argon plasma coagulation and photodynamic therapy: a randomized prospective trial assessing efficacy and cost-effectiveness”. Scandinavian Journal of Gastroenterology 7 (2005): 750-758.
- Global cancer observatory. Bangladesh (2019).
- Shil BC., et al. “Oesophageal carcinoma: trends and
risk factors in rural Bangladesh”. Journal of Dhaka Medical College1 (2010): 29-32.
- Staudenmann DA., et al. “Safety and long-term efficacy of hybrid-argon plasma coagulation for the treatment of Barrett’s esophagus: an Australian pilot study (with video)”. International Journal of Gastrointestinal Intervention 10 (2021): 128-132.
- Knabe M., et al. “Hybrid APC in combination with resection for the endoscopic treatment of neoplastic Barrett’s esophagus: a prospective, multicenter study”. American Journal of Gastroenterology 117 (2022): 110-119.
- Manner H., et al. “Efficacy and safety of hybrid-APC for the ablation of Barrett’s esophagus”. Surgical Endoscopy 30 (2016): 1364-1370.
- Rösch T., et al. “Multicenter feasibility study of combined injection and argon plasma coagulation (Hybrid-APC) in the ablation therapy of neoplastic Barrett esophagus”. Gastrointestinal Endoscopy 5 (2017): AB154.
- Linn B., et al. “Hybrid argon plasma coagulation and radiofrequency ablation in Barrett’s esophagus”. Gastrointestinal Endoscopy 6 (2020): AB413.
- Kashin SV., et al. “The new hybrid argon plasma coagulation (hybrid APC) for endoscopic ablation of Barrett’s esophagus (BE): the results of the pilot trial”. Gastrointestinal Endoscopy 5 (2016): AB495.
- Shimizu T., et al. “Benefit, tolerance, and safety of hybrid argon plasma coagulation for treatment of Barrett’s esophagus: US pilot study”. Endoscopy International Open 9 (2021): E1870-E1876.
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