Ricerc@Sapienza

Gastric antral vascular ectasia (GAVE), or "watermelon stomach", is a rare condition that can cause gastrointestinal (GB) bleeding due to the rupture of newly formed blood vessels in the antral gastric mucosa.Medical treatment has not shown satisfactory results and surgery is generally considered a last resort, due to its increased risk of complications and mortality. Argon Plasma Coagulation (APC) has proven to be one of the effective techniques in the treatment of chronic radiation proctitis, and many centers have reported success with this treatment. APC is a thermoablative method that uses a high-frequency current to pass through argon gas to cause thermocoagulation. On the other hands, radiofrequency ablation (RFA) has also shown promise in the treatment of GAVE and actinic proctitis especially in patients who have failed other treatments, such as APC. International studies on the use of RFA for the treatment of GAVE end AP are few, with a low sample size and limited follow-up.The most recent reviews show the need for larger prospective randomized controlled trials in order to understand which endoscopic technique is the most effective in these cases. The aim of this prospective randomized controlled trial study was to examine the comparative efficacy of RFA and APC for the treatment of GAVE, in cirrhotic and non-cirrhotic patients, and AP managed at a single Academic Center. "Naive" patients with confirmed GAVE or AP were recruited to this study and divided into two main groups: GAVEnd (patients with GAVE) and ProctEnd (patients with AP). Each main group will be divided into two subgroups related to treatment with RFA or APC. Patients will be randomly assigned to each group. Randomisation will be carried out using a previously developed randomisation table. The primary outcome will be the efficacy of APC and RFA. Secondary outcomes will include tolerability and feasibility.