[Long-term follow-up of patients with gastric antral vascular ectasia treated with argon plasma coagulation]. / Seguimiento a largo plazo de pacientes con ectasia vascular del antro gástrico tratados mediante coagulación con argón plasma.

BACKGROUND AND OBJECTIVE: Due to its easy use and low complication rates, argon plasma coagulation (APC) it is most common method of endoscopic treatment for gastric antral vascular ectasia (GAVE). We analyze both the long term effectiveness of APC for the treatment of GAVE and its side effects. MATERIAL AND METHODS: A retrospective review of GAVE patients treated with APC and followed up for a minimum of 24 months was done. RESULTS: Eighteen patients (mean age 67,16+/-13,53; 11 women) were included. Five initially presented with acute bleeding and 13 with anemia. GAVE eradication was achieved over 3.38+/-1,4 sessions per patient. There were no major complications. Five patients had mild bleeding and 11 complained of abdominal pain, that was self-limited during treatment. Seven patients relapsed (39%); 3 of them with melenae and 4 with anemia. Two patients with hypergastrinemia developed hyperplastic polyps. No differences were found between relapsers and non-relapsers. CONCLUSIONS: APC is a safe and effective technique for the treatment of GAVE. The recurrence rates increase gradually over time. Early action on recurrence would require improved clinical follow-up and blood test monitoring.

Minor adverse events of colonoscopy on ambulatory patients: the impact of moderate sedation.

BACKGROUND: Minor complications in colonoscopy, such as pain, distension, headache, dizziness, etc. are an important cause for the rejection of colonoscopy procedure. Their incidence, however, has not been established. OBJECTIVE: To determine minor complication rates in outpatient colonoscopy procedures and the effect of sedation on these complications. PATIENTS: A prospective randomized cohort study was performed on 1250 adults selected randomly among patients referred to our endoscopy unit. Complications and undesirable affects related to the colonoscopy were reordered during the patients' stay in the endoscopy unit (early complications) and 30 days postprocedure (late complications). RESULTS: One thousand one hundred and twenty-six patients were enrolled (mean age 50.43+/-13.7 years; 54.5% female), of which 875 (78%) were sedated and 251 (22%) were not. No difference between groups was observed. Thirty-one percent of the patients had early minor complications (25% among sedated patients; 52% of nonsedated patients; P<0.001 chi2); 23% had late minor complications (16% of sedated patients vs. 51% nonsedated patients; P<0.001 chi2). The most common undesirable effects were pain and abdominal distension. The risk of experiencing complications - odds ratio - was 1.013 times higher per year of age [confidence interval (CI) 95%: 1.004-1.022]; 1.953 times higher per increase in American Society of Anesthesiologists classification (95% CI: 1.524-2.504); and 0.116 times lower when sedation was used (95% CI: 0.079-0.170). CONCLUSION: Minor complications of colonoscopy are common. Their incidence increases with age and American Society of Anesthesiologists class and decreases with the use of sedation.