Efficacy and Safety of HAPC in Barrett's Esophagus – A Multicenter Italian Prospective Study
Background and study aims. Hybrid argon plasma coagulation (H-APC) is a novel technique for the ablation of neoplastic Barrett Esophagus (BE), consisting in submucosal fluid injection and subsequent APC of visible BE. Aim of this study was to assess H-APC efficacy, safety and tolerability. Patients...
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Georg Thieme Verlag KG
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-2531-8227 |
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| author | Davide Massimi Roberta Maselli Silvia Pecere Cristiano Spada Gianluca Andrisani Francesco Maria Di Matteo Antonella La Terra Franco Coppola Antonio Capogreco Roberto De Sire Ludovico Alfarone Maddalena Menini Marco Spadaccini Cesare Hassan Alessandro Repici |
| author_facet | Davide Massimi Roberta Maselli Silvia Pecere Cristiano Spada Gianluca Andrisani Francesco Maria Di Matteo Antonella La Terra Franco Coppola Antonio Capogreco Roberto De Sire Ludovico Alfarone Maddalena Menini Marco Spadaccini Cesare Hassan Alessandro Repici |
| author_sort | Davide Massimi |
| collection | DOAJ |
| description | Background and study aims.
Hybrid argon plasma coagulation (H-APC) is a novel technique for the ablation of neoplastic Barrett Esophagus (BE), consisting in submucosal fluid injection and subsequent APC of visible BE. Aim of this study was to assess H-APC efficacy, safety and tolerability.
Patients and methods.
We prospectively included patients undergoing H-APC ablation at 4 Italian Hospitals from September 2022 to March 2024. Patients with BE C3M5 maximum extent, low- or high-grade dysplasia (LGD, HGD) or residual BE after endoscopic resection (ER) of visible lesions were included. Patients who had undergone previous ablative treatments were excluded. The primary endpoints were the complete eradication of intestinal metaplasia (CE-IM) and dysplasia (CE-D). The secondary endpoints were safety in terms of major and minor adverse events (AEs) and tolerability, assessed using pain (0-10) and dysphagia (0-5) scores within 7 days post-ablation. (NCT05645679)
Results.
Among the 51 enrolled patients (mean C 0.43 cm (SD 0.72), mean M 2.20 cm (SD 1.09)) who completed the treatment (80 H-APC sessions), 45.1% (23/51) had prior ER of visible lesions . All patients achieved both CE-IM and CE-D (51/51), requiring a mean of 1.51 (SD 0.83) sessions. Only one case of fever and absolute dysphagia was observed, 1/51 (1,96%) AEs. Regarding tolerability, mean pain score was 1.3 (SD 1.99) while mean dysphagia score was 1.28 (SD 0.56).
Conclusions.
The H-APC technique showed promising results in terms of effectiveness and safety with a good tolerability in achieving initial CE-IM and CE-D in a selected population of BE patients. |
| format | Article |
| id | doaj-art-e8eabdcb022a4744b2126d89d4a2c038 |
| institution | Kabale University |
| issn | 2364-3722 2196-9736 |
| language | English |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj-art-e8eabdcb022a4744b2126d89d4a2c0382025-02-04T00:02:14ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-973610.1055/a-2531-8227Efficacy and Safety of HAPC in Barrett's Esophagus – A Multicenter Italian Prospective StudyDavide Massimi0https://orcid.org/0000-0002-0926-514XRoberta Maselli1Silvia Pecere2https://orcid.org/0000-0002-4401-7344Cristiano Spada3Gianluca Andrisani4Francesco Maria Di Matteo5Antonella La Terra6Franco Coppola7Antonio Capogreco8https://orcid.org/0000-0002-2212-2266Roberto De Sire9Ludovico Alfarone10Maddalena Menini11Marco Spadaccini12https://orcid.org/0000-0002-2939-6876Cesare Hassan13Alessandro Repici14Digestive Endoscopy Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Biomedical Sciences, Humanitas UniversityDigestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, ItalyDigestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, ItalyDigestive Endoscopy Unit, Campus Bio-Medico University Hospital, Roma, ItalyDigestive Endoscopy Unit, Campus Bio-Medico University Hospital, Roma, ItalyEndoscopy Unit, Ospedale San Giovanni Bosco, Torino, ItalyEndoscopy Unit, Ospedale San Giovanni Bosco, Torino, ItalyDigestive Endoscopy Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDigestive Endoscopy Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDigestive Endoscopy Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDigestive Endoscopy Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDigestive Endoscopy Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, ItalyDepartment of Biomedical Science, Humanitas University, Pieve Emanuele, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalyBackground and study aims. Hybrid argon plasma coagulation (H-APC) is a novel technique for the ablation of neoplastic Barrett Esophagus (BE), consisting in submucosal fluid injection and subsequent APC of visible BE. Aim of this study was to assess H-APC efficacy, safety and tolerability. Patients and methods. We prospectively included patients undergoing H-APC ablation at 4 Italian Hospitals from September 2022 to March 2024. Patients with BE C3M5 maximum extent, low- or high-grade dysplasia (LGD, HGD) or residual BE after endoscopic resection (ER) of visible lesions were included. Patients who had undergone previous ablative treatments were excluded. The primary endpoints were the complete eradication of intestinal metaplasia (CE-IM) and dysplasia (CE-D). The secondary endpoints were safety in terms of major and minor adverse events (AEs) and tolerability, assessed using pain (0-10) and dysphagia (0-5) scores within 7 days post-ablation. (NCT05645679) Results. Among the 51 enrolled patients (mean C 0.43 cm (SD 0.72), mean M 2.20 cm (SD 1.09)) who completed the treatment (80 H-APC sessions), 45.1% (23/51) had prior ER of visible lesions . All patients achieved both CE-IM and CE-D (51/51), requiring a mean of 1.51 (SD 0.83) sessions. Only one case of fever and absolute dysphagia was observed, 1/51 (1,96%) AEs. Regarding tolerability, mean pain score was 1.3 (SD 1.99) while mean dysphagia score was 1.28 (SD 0.56). Conclusions. The H-APC technique showed promising results in terms of effectiveness and safety with a good tolerability in achieving initial CE-IM and CE-D in a selected population of BE patients.http://www.thieme-connect.de/DOI/DOI?10.1055/a-2531-8227 |
| spellingShingle | Davide Massimi Roberta Maselli Silvia Pecere Cristiano Spada Gianluca Andrisani Francesco Maria Di Matteo Antonella La Terra Franco Coppola Antonio Capogreco Roberto De Sire Ludovico Alfarone Maddalena Menini Marco Spadaccini Cesare Hassan Alessandro Repici Efficacy and Safety of HAPC in Barrett's Esophagus – A Multicenter Italian Prospective Study Endoscopy International Open |
| title | Efficacy and Safety of HAPC in Barrett's Esophagus – A Multicenter Italian Prospective Study |
| title_full | Efficacy and Safety of HAPC in Barrett's Esophagus – A Multicenter Italian Prospective Study |
| title_fullStr | Efficacy and Safety of HAPC in Barrett's Esophagus – A Multicenter Italian Prospective Study |
| title_full_unstemmed | Efficacy and Safety of HAPC in Barrett's Esophagus – A Multicenter Italian Prospective Study |
| title_short | Efficacy and Safety of HAPC in Barrett's Esophagus – A Multicenter Italian Prospective Study |
| title_sort | efficacy and safety of hapc in barrett s esophagus a multicenter italian prospective study |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-2531-8227 |
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