Gut and Liver 2008; 2(2): 95-98 https://doi.org/10.5009/gnl.2008.2.2.95 Submucosal Injection of Normal Saline can Prevent Unexpected Deep Thermal Injury of Argon Plasma Coagulation in the in vivo Porcine Stomach
Author Information
Mitsuhiro Fujishiro*, Shinya Kodashima*, Satoshi Ono*, Osamu Goto*, Nobutake Yamamichi*, Naohisa Yahagi*, Koji Kashimura, Toyokazu Matsuura, Mikitaka Iguchi§, Masashi Oka§, Masao Ichinose§, and Masao Omata*
*Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Product Research Department, Kamakura Research Laboratories, Chugai Pharmaceutical Co., LTD., Kamakura, Kanagawa, Chugai Research Institute for Medical Science, INC., Gotenba, Shizuoka, and §Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan

Mitsuhiro Fujishiro
© The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. All rights reserved.

Abstract
Background/Aims: There have been several reports of thermal injury induced by argon plasma coagulation (APC) in animal models, but no follow-up studies have revealed the actual thermal injury. Methods: APC was performed on the stomachs of two living minipigs with and without prior submucosal injection of normal saline. The power and argon gas flow were set to 60 watts and 2 L/min, respectively, and pulse durations of 5, 10, and 20 seconds were used. One of the minipigs was killed immediately thereafter and the other was killed 1 week later. Results: The minipig killed immediately showed only subtle differences between noninjected and injected injuries under all the conditions, and the usefulness of prior submucosal injection was not obvious. However, the minipig killed 1 week later had a deep ulcer extending to the deeper muscle layer at the noninjected site where APC had been applied for 20 seconds, whereas tissue injury of the injected site was limited to the submucosal layer. Conclusions: Unexpected tissue damage can occur even using a short-duration APC. Prior submucosal injection for APC might be a safer alternative technique, especially in a thinner and narrower gut wall. (Gut and Liver 2008;2:95-98)
Keywords: Argon; Submucosa; Injection; Animal model; Thermal
Abstract
Background/Aims: There have been several reports of thermal injury induced by argon plasma coagulation (APC) in animal models, but no follow-up studies have revealed the actual thermal injury. Methods: APC was performed on the stomachs of two living minipigs with and without prior submucosal injection of normal saline. The power and argon gas flow were set to 60 watts and 2 L/min, respectively, and pulse durations of 5, 10, and 20 seconds were used. One of the minipigs was killed immediately thereafter and the other was killed 1 week later. Results: The minipig killed immediately showed only subtle differences between noninjected and injected injuries under all the conditions, and the usefulness of prior submucosal injection was not obvious. However, the minipig killed 1 week later had a deep ulcer extending to the deeper muscle layer at the noninjected site where APC had been applied for 20 seconds, whereas tissue injury of the injected site was limited to the submucosal layer. Conclusions: Unexpected tissue damage can occur even using a short-duration APC. Prior submucosal injection for APC might be a safer alternative technique, especially in a thinner and narrower gut wall. (Gut and Liver 2008;2:95-98)
Keywords: Argon; Submucosa; Injection; Animal model; Thermal
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