HYBRID ARGON PLASMA COAGULATION IN THE TREATMENT OF BARRETT'S ESOPHAGUS: AN EXPERIMENT

Background. Barrett's esophagus (BE) is a precancerous condition marked by the transformation of squamous epithelium into columnar epithelium. Traditionally, radiofrequency ablation (RFA) has been the standard treatment, but newer methods like hybrid argon plasma coagulation (APC) and cryotherapy are emerging as alternatives. Aim. To compare the effects of various lifting fluids on the efficiency of performing hybrid APC in the treatment of BE. Methods. The experiment was conducted on pig esophagi. Various lifting fluids (0.9% sodium chloride, 4% gelatin, and 6% hydroxyethyl starch) were used. A gastroscope, an electrosurgical unit with an APC2 module, and endoscopic needles were employed. Pathological analyses were performed to assess the efficacy of the lifting fluids and compare hybrid APC to standard APC. Nine procedures were conducted, including classic APC and hybrid APC using different fluids and power settings. Results. Classic APC at 30 watts showed limited mucosal coagulation, while at 60 watts, full coagulation with significant submucosal damage was observed. Hybrid APC with colloid solutions provided longer lifting duration, reducing the need for reinjections. At 30 and 60 watts, hybrid APC preserved the submucosal and muscular layers, with complete mucosal coagulation at higher wattages. Conclusions. Hybrid APC offers an effective alternative to traditional methods for treating Barrett's esophagus, with fewer complications and increasing global adoption.