Argon plazma koagülasyon: Durdurulamayan özofagus varis kanamalarında alternatif endoskopik kurtarma tedavisi olabilir mi?

Özofagus varis kanaması portal hipertansiyonun 6 haftalık mortalite oranının yaklaşık %20 olduğu yaşamı tehdit edici bir komplikasyonudur. Günümüz verisi vazoaktif ilaçlarla endoskopik varis ligasyonu, antibiyotik kombinasyonunun en iyi tedavi edici yöntem olduğunu desteklemektedir. Doku yapıştırıcılar, endolooplar, endoskopik klipsleme ve argon plazma koagülasyon kontrol edilemeyen özofagus varis kanamasında kullanılmaktadır.

Can argon plasma coagulation be endoscopic recovery treatment in uncontrolled esophageal varices bleeding?

Esophageal variceal bleeding is a life-threatening complication of portal hypertension with a six-week mortality rate of approximately 20%. The available data suggest that vasoactive drugs, combined with endoscopic therapy and antibiotics, are the best treatment strategy with endoscopic variceal ligation being the endoscopic procedure of choice. Tissue adhesives, endoloops, endoscopic clipping and argon plasma coagulation, have been used in the management of uncontrolled esophageal varices bleeding. 

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  • Calès P, Pascal JP. Natural history of esophageal varices in cirrhosis (from origin to rupture) Gastroenterol Clin Biol 1988;12:245-54
  • Villanueva C, Colomo A, Aracil C et al. Current endoscopic therapy of variceal bleeding. Best Pract Res Clin Gastroenterol 2008;22:261-78
  • Harras F, Sheta el S, Shehata M, et al. Endoscopic band ligation plus argon plasma coagulation versus scleroligation for eradication of esophageal varices. J Gastroenterol Hepatol 2010;25:1058-65.
  • van Vilsteren FG, Pouw RE, Seewald S, et al. Stepwise radical endoscopic resection versus radiofrequency ablation for Barrett’s oesophagus with high-grade dysplasia or early cancer: a multicentre randomised trial. Gut 2011;60:765-73.
  • Olmos JA, Marcolongo M, Pogorelsky V, et al. Argon plasma coagulation for prevention of recurrent bleeding from GI angiodysplasias. Gastrointest Endosc 2004;60:881-6.
Endoskopi Gastrointestinal-Cover
  • ISSN: 1302-5422
  • Başlangıç: 2010
  • Yayıncı: Türk Gastroenteroloji Vakfı