Modern possibilities of endoscopic hybrid argon plasma ablation in patients with Barrett's esophagus in combination with hiatal hernia

Annotation. Barrett's esophagus (BE) is a manifestation and complication of gastroesophageal reflux disease and is a precancerous condition that can develop into esophageal adenocarcinoma. BE is a transformation process in which metaplastic columnar epithelium replaces the natural stratified squamous epithelium in the lower part of the esophagus. A retrospective study of 73 cases of hybrid argon plasma coagulation in patients with Barrett's esophagus and hiatal hernia was conducted. During endoscopic surgical treatment, a diagnostic gastroscope (GIF-EZ1500; Olympus), an electrosurgical unit with an APC2 unit (VIO 200 D) with an ERBEJET2 system, and a 25G endoscopic needle were used. Diagnosis was performed using high-resolution endoscopy, narrow-band imaging (NBI), and 2% acetic acid solution. All patients underwent hybrid argon plasma ablation with follow-up examinations at 3, 6, and 12 months. One year after endoscopic surgical treatment, all patients had complete resolution of metaplastic changes characteristic of Barrett's esophagus. Side effects were minimal, and quality of life significantly improved. After endoscopic treatment, 63% of patients underwent laparoscopic surgery for hiatal hernia, and 37% continued maintenance therapy. Thus, the study proved that such an alternative method of treatment of Barrett's esophagus as hybrid argon plasma ablation is effective and safe, allows to achieve complete regression of the disease and significantly improve the prognosis for patients with this pathology. This method has a lower risk of postoperative complications and is used by surgeons around the world. Further studies will be aimed at repeated retrospective studies of groups of patients who underwent hybrid argon plasma ablation, determining the risks of complications, studying the effect of the method on preventing the development of adenocarcinoma.