Original Article
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World J Gastrointest Endosc. Jul 16, 2014; 6(7): 304-311
Published online Jul 16, 2014. doi: 10.4253/wjge.v6.i7.304
Histology assessment of bipolar coagulation and argon plasma coagulation on digestive tract
Teresa Garrido, Elisa R Baba, Stephanie Wodak, Paulo Sakai, Ivan Cecconello, Fauze Maluf-Filho
Teresa Garrido, Elisa R Baba, Stephanie Wodak, Paulo Sakai, Ivan Cecconello, Fauze Maluf-Filho, Endoscopy Division and Gastrointestinal Surgery Division, Hospital das Clinicas of the University of São Paulo, São Paulo, SP 05403-000, Brazil
Author contributions: Garrido T performed the research, analysis and interpretation of the data; Baba ER and Wodak S made the analysis and interpretation of the data, drafting of the article; Sakai P and Cecconello I performed a critical revision of the article for important intellectual content; Maluf-Filho F made the conception and design of the study, analysis and interpretation of the data, critical revision of the article for important intellectual content and final approval of the article.
Supported by University of São Paulo Medical School
Correspondence to: Dr. Fauze Maluf-Filho, Professor, Endoscopy Division and Gastrointestinal Surgery Division, Hospital das Clinicas of the University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, São Paulo, SP 05403-000, Brazil. fauze.maluf@terra.com.br
Telephone: +55-11-3069-7579
Received: January 13, 2014
Revised: May 26, 2014
Accepted: June 10, 2014
Published online: July 16, 2014
Abstract

AIM: To analyze the effect of bipolar electrocoagulation and argon plasma coagulation on fresh specimens of gastrointestinal tract.

METHODS: An experimental evaluation was performed at Hospital das Clinicas of the University of São Paulo, on 31 fresh surgical specimens using argon plasma coagulation and bipolar electrocoagulation at different time intervals. The depth of tissue damage was histopathologically analyzed by single senior pathologist unaware of the coagulation method and power setting applied. To analyze the results, the mucosa was divided in superficial mucosa (epithelial layer of the esophagus and superficial portion of the glandular layer of the stomach and colon) intermediate mucosa (until the lamina propria of the esophagus and until the bottom of the glandular layer of the stomach and colon) and muscularis mucosa. Necrosis involvement of the layers was compared in several combinations of power and time interval.

RESULTS: Involvement of the intermediate mucosa of the stomach and of the muscularis mucosa of the three organs was more frequent when higher amounts of energy were used with argon plasma. In the esophagus and in the colon, injury of the intermediate mucosa was frequent, even when small amounts of energy were used. The use of bipolar electrocoagulation resulted in more frequent involvement of the intermediate mucosa and of the muscularis mucosa of the esophagus and of the colon when higher amounts of energy were used. In the stomach, these involvements were rare. The risk of injury of the muscularis propria was significant only in the colon when argon plasma coagulation was employed.

CONCLUSION: Tissue damage after argon plasma coagulation is deeper than bipolar electrocoagulation. Both of them depend on the amount of energy used.

Keywords: Argon plasma coagulation, Electrocoagulation, Gastrointestinal endoscopy, Surgical procedures, Endoscopic gastrointestinal, Mucous membrane/injuries

Core tip: The best way of applying heat to hollow digestive organs during thermal endoscopic therapy has not been clearly established so far. This study analyzes the histophathological effect of bipolar electrocoagulation and argon plasma coagulation on fresh surgical specimens of the digestive tract. Tissue damage after argon plasma coagulation is deeper than bipolar electrocoagulation. Both of them depends on the amount of energy used.