Abstract

CASTANO, Rodrigo et al. Endoscopic argon plasma therapy for neuroendocrine type I gastric tumors. Rev Col Gastroenterol [online]. 2014, vol.29, n.1, pp.26-34. ISSN 0120-9957.

Background and Purpose: Since data regarding type I gastric carcinoid tumors and their evolution in prospective studies are scarce, unanimity has not been reached regarding treatment and follow-up. Our purpose is to describe the use of argon plasma coagulation (APC) for the eradication of multiple type I gastric carcinoid tumors and to observe behavior over time following treatment. Methods: Over a period of seven years from July 2005 to June 2012, fourteen patients with neuroendocrine gastric tumors were treated endoscopically at two tertiary medical centers. Argon plasma was applied to eradicate multiple gastric carcinoid tumors. Then, patients underwent follow-up endoscopic examinations. Results: None of the patients presented specific symptoms or signs related to the presence of chronic atrophic gastritis, and all diagnoses were incidental findings during endoscopy. Biopsies obtained endoscopically prior to intervention showed polyps that were type I intramucosal neuroendocrine tumors. The median diameter was 3.8 mm, with a range from 2mm to 10mm. Seven cases (50%) were associated severe atrophy while multifocal atrophy was found in 29% of the cases. H. pylori were found in seven patients (50%) during an average follow-up of 46 months. Follow-up periods ranged from 17 to 84 months. Patient survival was 100%. Even though ten patients (71%) suffered recurrences, all lesions were eradicated. Gastrin, chromogranin A, mitotic index, and Ki 67 were all evaluated, and patients were also tested for autoimmune diseases. No bleeding or perforations occurred during procedures. Conclusions: The use of endoscopic argon plasma to completely eradicate type I gastric neuroendocrine tumors is safe and easy.

Keywords : Type I gastric neuroendocrine tumors; endoscopy; argon plasma.

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