DOI: https://doi.org/10.36347/sjmcr.2026.v14i10.039

Pages: 2289-2292

Background: Argon plasma coagulation (APC) is the standard endoscopic treatment for bleeding gastrointestinal vascular lesions. Although APC is highly effective, the number of sessions required varies considerably among patients, and predictive factors for requiring multiple sessions remain poorly defined. Objective: To identify factors associated with requiring multiple (≥2) APC sessions in patients treated at the Mohammed V Military Instruction Hospital (HMIMV) in Rabat, Morocco. Methods: A retrospective analytical study including all patients treated with APC between January 2020 and December 2025 at the Department of Gastroenterology of HMIMV. Patients were divided into two groups: 1 session vs. ≥2 sessions. Demographic, clinical, and endoscopic variables were compared between groups using univariate analysis (Chi-square test, Fisher's exact test). Results: A total of 199 patients were included. The majority of patients (58.3%) required ≥2 APC sessions (median: 2 sessions; range: 1–8). In univariate analysis, two factors were significantly associated with the need for multiple sessions: the presence of coded medical history (OR = 2.63; p = 0.002) and type 1 APC indication (OR = 2.56; p = 0.002). A trend was observed for the number of lesions (≥3 lesions: OR = 2.16; p = 0.078). Age, sex, lesion location, active bleeding, and adjuvant therapies were not significantly associated with the number of sessions. Conclusion: In our series, the presence of medical comorbidities and the specific type of APC indication were associated with the need for multiple treatment sessions. These findings suggest that patients with comorbidities and specific indications require closer follow-up and potentially more intensive initial therapy. Prospective studies with multivariate analysis are required to confirm these predictive factors.