Hybrid argon plasma coagulation: a new modality for treatment of a diffuse foregut anastomotic dysplastic lesion

摘要

A 91-year-old man with a history of Roux-en-Y GJ for gastric bypass was referred for further management of a diffusely spreading dysplastic lesion at the GJ anasto- mosis (Fig. 1). Hybrid APC was used with 30 bars (435 psi) for injection with the probe at the base of the lesion. After optimal lift of the mucosal area at the lesion site, APC was performed at 60 W pulsed 2 for ablation. The treated area was then removed by use of the mucosal scraping technique with a soft cap attached to the distal end of the gastroscope. Repeated injection-APC was performed to the newly exposed tis- sue base (Fig. 2). The patient was admitted overnight for observation and was discharged the next day.