Argon plasma coagulation for GI bleed:

Argon Plasma Coagulation or APC is the medical procedure that is helpful in controlling bleeding from lesions in the gastrointestinal tract. For some patients in whom surgery is not recommended, this is used to debulk tumors. Gastrointestinal bleeding management is challenging mainly in people with cancer. Argon Plasma Coagulation is a primarily endoscopic hemostatic method that is very much effective in managing non-neoplastic cause of GIB involving radiation proctitis, arterio-venous malformation, and gastric antral vascular ectasia.
Some conditions for which APC is used are as:

  • Colonic Polyps after Polypectomy
  • Gastric antral vascular ectasia
  • Angiodysplasias
  • Radiation proctitis
  • Esophageal Cancer

Endoscopic Argon Plasma Coagulation Therapy

This therapy is done with APC probe. An APC is a non-contact electrocoagulation device that transfers high frequency monopolar altering current via argon gas to target tissue. There happens tissue desiccation at the contact interface of tissue. High-frequency electric current is passed through a jet of gases causing in coagulation of bleeding lesions on another side of the lesion. This procedure is safe as there is no contact with the lesion.
Endoscopic banding ligation in combination with argon plasma coagulation is the best approaches. Bleeding from gastrointestinal tumors in cancer patients and its management is highly challenging condition. Bleeding from gastrointestinal tumors can result in acute gastrointestinal hemorrhage. Therefore, patients having metastatic tumors have a huge risk of tumor-related bleeding. APC provides contact-free ablation and is useful with brush-like strokes over oozing tissue. APC is the therapy of choice for a tumor with diffuse bleeding.

Conclusion

As per our experience, APC is feasible and safest method in routine practice for managing bleeding gastrointestinal tumors. APC is a promising technique for tumor-related gastrointestinal bleeding for the achievement of initial hemostasis. Further studies are still going on for using APC singly or in combination with other hemostatic modalities.

dr-kapil-sharma-1

Dr. Kapil Sharma

MBBS, MD, DM Gastroenterology
Director and Head Gastroenterology Batra Hospital and Medical research centre, New Delhi.

He had more than 15 years of experience in field of Gastroenterology and Hepatology.

As a committed doctor, he had undergone advance endoscopic training in endoscopic ultrasound and third space endoscopy. Now he is amongst few Gastroenterologist across the country who do interventional endoscopic ultrasound and per oral endoscopic myotomy.

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