The efficacy and safety of argon plasma coagulation therapy in Barrett's esophagus

Gastrointest Endosc. 1999 Jul;50(1):18-22. doi: 10.1016/s0016-5107(99)70338-x.


Background: Thermoablation is being used to eliminate the metaplastic epithelium of Barrett's esophagus and allow its reversal into squamous epithelium in an acid-controlled environment. This study assessed the efficacy and safety of a new thermoablation technique, argon plasma coagulation.

Methods: Patients with circumferential Barrett's esophagus 2 to 5 cm long were enrolled. Acid suppression was accomplished with lansoprazole. One-half the circumference of Barrett's mucosa was treated with argon plasma coagulation, and the other half served as an internal control. After macroscopic squamous re-epithelialization occurred, biopsy specimens were obtained from both areas systematically.

Results: Nine patients, all men with a mean age of 51.1 years, completed the study. During 24-hour esophageal pH monitoring a pH less than 4 occurred on average 2.8% of the time with a mean dose of lansoprazole of 70 mg/day. Squamous re-epithelialization developed in treated areas in all 9 patients. Biopsy showed that 7 of 9 patients (77.8%) had squamous re-epithelialization without intestinal metaplasia. Biopsy showed that 2 of 9 patients (22.2%) had squamous re-epithelialization with evidence of underlying intestinal metaplasia. There were no serious complications.

Conclusions: Argon plasma coagulation in an acid-controlled environment was both efficacious and safe in the treatment of Barrett's esophagus. However, the reappearance of squamous epithelium after therapy did not exclude the presence of underlying intestinal metaplasia.

MeSH terms

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Anti-Ulcer Agents / therapeutic use
  • Barrett Esophagus / pathology
  • Barrett Esophagus / surgery*
  • Biopsy
  • Endoscopes
  • Endoscopy / adverse effects
  • Endoscopy / methods*
  • Endoscopy / statistics & numerical data
  • Esophagoscopy
  • Esophagus / pathology
  • Esophagus / surgery
  • Humans
  • Lansoprazole
  • Light Coagulation / adverse effects
  • Light Coagulation / instrumentation
  • Light Coagulation / methods*
  • Light Coagulation / statistics & numerical data
  • Male
  • Middle Aged
  • Omeprazole / analogs & derivatives
  • Omeprazole / therapeutic use
  • Preoperative Care
  • Safety


  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Anti-Ulcer Agents
  • Lansoprazole
  • Omeprazole