Ablation of Nonneoplastic Barrett's Mucosa Using Argon Plasma Coagulation with Concomitant Esomeprazole Therapy (APBANEX): A Prospective Multicenter Evaluation

Manner, Hendrik; May, Andrea; Miehlke, Stephan; Dertinger, Stephan; Wigginghaus, Bernd; Schimming, Wolfgang; Krämer, Walter; Niemann, Gabriele; Stolte, Manfred; Ell, Christian

doi:10.1111/j.1572-0241.2006.00709.x

Cited by 94 publications

(74 citation statements)

References 27 publications

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“…4,10 By using APC or RFA for ablation, complete eradication of neoplastic lesions in the Barrett's segment can be reached in 93%-97% of cases. 3,10 Complete eradication of all Barrett's metaplasia is possible in 77%-88% of cases. 3,10 All methods have the disadvantage of developing post-therapeutic stenosis.…”

Section: Discussionmentioning

confidence: 99%

“…2 As a result of considerable technical efforts using PDT and management of relevant side effects for patients, argon-plasma coagulation (APC) became the standard treatment for non-neoplastic intestinal metaplasia in the esophagus. 3 Using APC for ablation of the remaining Barrett's mucosa after endoscopic resection, the recurrence of metachronous lesions can be reduced substantially. 4 Another alternative option for this indication is the use of radiofrequency ablation (RFA).…”

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confidence: 99%

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Non‐thermal ablation of non‐neoplastic Barrett's esophagus with the novel EndoRotor® resection device

Knabe¹,

Blößer²,

Wetzka³

et al. 2018

UEG Journal

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Background: International guidelines suggest endoscopic resection for all patients with low-risk mucosal cancer. Ultimately, it is essential to treat the remaining Barrett's esophagus as part of the treatment. Different thermal ablative therapies have been implemented to effect this treatment. They can lead to potential post-therapeutic stenosis. Furthermore, a histologic assessment of treated mucosa is not possible. Objective: Clinical evaluation of a novel, non-thermal resection device (EndoRotor Õ ) in the treatment of non-neoplastic Barrett's esophagus was conducted. Methods: Fourteen patients with early Barrett's carcinoma were treated with endoscopic resection. Subsequently, EndoRotor Õ therapy was performed for resection of the remaining Barrett's mucosa. Complications were assessed during the study. After a three-month period patients received follow-up endoscopy to evaluate post-therapeutic stenosis. Results: On average, 674 mm 2 (172 mm 2 -1600 mm 2 ) of Barrett's mucosa was treated with the novel device. In six (37.5%) cases, intra-procedural bleeding occurred with the need for hemostasis. All bleeding could be managed by endoscopic therapy alone. After a three-month follow-up there was no post-therapeutic stenosis registered. Conclusion: EndoRotorÕ resection is a feasible non-thermal treatment of non-neoplastic Barrett's esophagus. Larger trials have to evaluate risks and benefits of this novel device.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Non‐thermal ablation of non‐neoplastic Barrett's esophagus with the novel EndoRotor® resection device

Knabe¹,

Blößer²,

Wetzka³

et al. 2018

UEG Journal

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“…Randomized trials report up to 4% of bleeding, 2% of oesophageal perforation and 6% of stricture formation in oesophagus [61]. Colonic use of APC, can be associated with a rare but dreaded event -colon explosion -that may lead to perforation and emergency surgery.…”

Section: Ablation Techniquesmentioning

confidence: 99%

Emergencies after endoscopic procedures

Rolanda

Caetano

Dinis-Ribeiro

2013

Best Practice & Research Clinical Gastroenterology

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Keywords:GI endoscopy adverse events GI emergencies Bleeding Haemorrhage Perforation Infection Embolization Diagnosis and management of severe complications a b s t r a c t Endoscopy adverse events (AEs), or complications, are a rising concern on the quality of endoscopic care, given the technical advances and the crescent complexity of therapeutic procedures, over the entire gastrointestinal and bilio-pancreatic tract. In a small percentage, not established, there can be real emergency conditions, as perforation, severe bleeding, embolization or infection. Distinct variables interfere in its occurrence, although, the awareness of the operator for their potential, early recognition, and local organized facilities for immediate handling, makes all the difference in the subsequent outcome. This review outlines general AEs' frequencies, important predisposing factors and putative prophylactic measures for specific procedures (from conventional endoscopy to endoscopic cholangio-pancreatography and ultrasonography), with comprehensive approaches to the management of emergent bleeding and perforation.

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“…[9][10][11][12][13] First reports on the use of argon plasma for tumor removal date back to 1989 14 , followed by successful ablation of nonneoplastic Barrett's mucosa 15 and other neoplastic diseases. [16][17][18][19][20][21] A plasma-activated medium has even been claimed to exert anti-tumor effects.…”

Section: Introductionmentioning

confidence: 99%

Cold atmospheric pressure plasma for treatment of chronic wounds: drug or medical device?

et al. 2017

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Objective: The use of cold atmospheric pressure plasma (CAPP) as a new therapeutic option to aid the healing of chronic wounds appears promising. Currently, uncertainty exists regarding their classification as medical device or medical drug. Because the classification of CAPP has medical, legal, and economic consequences as well as implications for the level of preclinical and clinical testing, the correct classification is not an academic exercise, but an ethical need. Method: A multidisciplinary team of physicians, surgeons, pharmacists, physicists and lawyers has analysed the physical and technical characteristics as well as legal conditions of the biological action of CAPP. Results: It was concluded that the mode of action of the locally generated CAPP, with its main active components being different radicals, is pharmacological and not physical in nature. Conclusion: Depending on the intended use, CAPP should be classified as a drug, which is generated by use of a medical device directly at the point of therapeutic application.

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Ablation of Nonneoplastic Barrett's Mucosa Using Argon Plasma Coagulation with Concomitant Esomeprazole Therapy (APBANEX): A Prospective Multicenter Evaluation

Abstract: Complete ablation of BE can be achieved in a high percentage of patients even in a multicenter design using high-power APC. However, APC has a relevant morbidity. Therefore, ablation of nonneoplastic BE cannot be recommended generally because incidence of cancer in BE is low.

Cited by 94 publications

References 27 publications

Non‐thermal ablation of non‐neoplastic Barrett's esophagus with the novel EndoRotor® resection device

Non‐thermal ablation of non‐neoplastic Barrett's esophagus with the novel EndoRotor® resection device

Emergencies after endoscopic procedures

Cold atmospheric pressure plasma for treatment of chronic wounds: drug or medical device?

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