Argon plasma coagulation for the endoscopic treatment of gastrointestinal tumor bleeding: A retrospective comparison with a non-treated historical cohort

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorMARTINS, Bruno Costa
dc.contributor.authorWODAK, Stephanie
dc.contributor.authorGUSMON, Carla C.
dc.contributor.authorSAFATLE-RIBEIRO, Adriana Vaz
dc.contributor.authorKAWAGUTI, Fabio Shiguehissa
dc.contributor.authorBABA, Elisa Ryoka
dc.contributor.authorPENNACCHI, Caterina M. P.
dc.contributor.authorLIMA, Marcelo Simas
dc.contributor.authorRIBEIRO JR., Ulysses
dc.contributor.authorMALUF-FILHO, Fauze
dc.date.accessioned2016-07-04T13:55:14Z
dc.date.available2016-07-04T13:55:14Z
dc.date.issued2016
dc.description.abstractBackground: The endoscopic use of argon plasma coagulation (APC) to achieve hemostasis for upper gastrointestinal tumor bleeding (UGITB) has not been adequately evaluated in controlled trials. This study aimed to evaluate the efficacy of APC for the treatment of upper gastrointestinal bleeding from malignant lesions. Methods: Between January and September 2011, all patients with UGITB underwent high-potency APC therapy (up to 70 Watts). This group was compared with a historical cohort of patients admitted between January and December 2010, when the endoscopic treatment of bleeding malignancies was not routinely performed. Patients were stratified into two categories, grouping the Eastern Cooperative Oncology Group (ECOG) performance status scale: Category I (ECOG 0-2) patients with a good clinical status and Category II (ECOG 3-4) patients with a poor clinical status. Results: Our study had 25 patients with UGITB whom underwent APC treatment and 28 patients whom received no endoscopic therapy. The clinical characteristics of the groups were similar, except for endoscopic active bleeding, which was more frequently detected in APC group. We had 15 patients in the APC group whom had active bleeding, and initial hemostasis was obtained in 11 of them (73.3%). In the control group, four patients had active bleeding. There were no differences in 30-day re-bleeding (33.3% in the APC group versus 14.3% in the control group; p=0.104) and 30-day mortality rates (20.8% in the APC group, versus 42.9% in the control group; p=0.091). When patients were categorized according to their ECOG status, we found that APC therapy had no impact in re-bleeding and mortality rates (Group I: APC versus no endoscopic treatment: re-bleeding p=0.412, mortality p=0.669; Group II: APC versus no endoscopic treatment: re-bleeding p=0.505, mortality p=0.580). Hematemesis and site of bleeding located at the esophagus or duodenum were associated with a higher 30-day mortality. Conclusions: Endoscopic hemostasis of UGITB with APC has no significant impact on 30-day re-bleeding and mortality rates, irrespective of patient performance status.
dc.description.indexPubMed
dc.identifier.citationUNITED EUROPEAN GASTROENTEROLOGY JOURNAL, v.4, n.1, p.49-54, 2016
dc.identifier.doi10.1177/2050640615590303
dc.identifier.eissn2050-6414
dc.identifier.issn2050-6406
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/13929
dc.language.isoeng
dc.publisherSAGE PUBLICATIONS INC
dc.relation.ispartofUnited European Gastroenterology Journal
dc.rightsrestrictedAccess
dc.rights.holderCopyright SAGE PUBLICATIONS INC
dc.subjectArgon plasma coagulation
dc.subjectbleeding
dc.subjectendoscopy
dc.subjectgastrointestinal cancer
dc.subjectgastrointestinal hemorrhage
dc.subjecthemostasis
dc.subjectmortality
dc.subjecttumor
dc.subject.othergi hemorrhage
dc.subject.othermanagement
dc.subject.othertherapy
dc.subject.otherexperience
dc.subject.othercancer
dc.subject.otherangiogenesis
dc.subject.otherlesions
dc.subject.otherlaser
dc.subject.wosGastroenterology & Hepatology
dc.titleArgon plasma coagulation for the endoscopic treatment of gastrointestinal tumor bleeding: A retrospective comparison with a non-treated historical cohort
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalWODAK, Stephanie:Univ Sao Paulo, Inst Canc, Endoscopy Div, Ave Dr Arnaldo 251,2nd Floor, BR-01246000 Sao Paulo, Brazil
hcfmusp.citation.scopus19
hcfmusp.contributor.author-fmusphcBRUNO DA COSTA MARTINS
hcfmusp.contributor.author-fmusphcCARLA CRISTINA GUSMON DE OLIVEIRA
hcfmusp.contributor.author-fmusphcADRIANA VAZ SAFATLE RIBEIRO
hcfmusp.contributor.author-fmusphcFABIO SHIGUEHISSA KAWAGUTI
hcfmusp.contributor.author-fmusphcELISA RYOKA BABA
hcfmusp.contributor.author-fmusphcCATERINA MARIA PIA SIMIONI PENNACCHI
hcfmusp.contributor.author-fmusphcMARCELO SIMAS DE LIMA
hcfmusp.contributor.author-fmusphcULYSSES RIBEIRO JUNIOR
hcfmusp.contributor.author-fmusphcFAUZE MALUF FILHO
hcfmusp.description.beginpage49
hcfmusp.description.endpage54
hcfmusp.description.issue1
hcfmusp.description.volume4
hcfmusp.origemWOS
hcfmusp.origem.pubmed26966522
hcfmusp.origem.scopus2-s2.0-84979461874
hcfmusp.origem.wosWOS:000370752800006
hcfmusp.publisher.cityTHOUSAND OAKS
hcfmusp.publisher.countryUSA
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