Ablative Endoscopic Therapies for Barrett’s-Esophagus-Related Neoplasia

Peter, Shajan; Mönkemüller, Klaus

doi:10.1016/j.gtc.2015.02.014

Cited by 14 publications

(10 citation statements)

References 72 publications

(65 reference statements)

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“…Endoscopic resection is essential in the initial management of nodular areas of BE to adequately stage and treat the disease, but it is often not sufficient for achieving CE-IM. Endoscopic ablation using photochemical, freezing, or thermal injury aims to eliminate BE by inducing superficial necrosis of the metaplastic tissue, which can effectively eliminate dysplastic potential and allow for reepithelialization with neo-squamous epithelium (22). These techniques, when used in conjunction with acid suppression therapy to maintain the integrity of the neo-epithelium, can help prevent the recurrence of BE altogether.…”

Section: Ablative Techniquesmentioning

confidence: 99%

Endoscopic therapies for Barrett’s esophagus

Ventre¹,

Shahid²

2021

Transl Gastroenterol Hepatol

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The management of Barrett's esophagus (BE) has evolved as newer technologies and novel methods are developed. Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) are the initial interventions of choice for nodular BE, with ESD reserved for endoscopists highly trained in the technique and for larger lesions that would warrant en bloc resection. Resection should then be followed by ablative therapy, which remains first line in the treatment of BE with dysplasia. Although there is a myriad of ablation techniques available to the endoscopist, this review has found that radiofrequency ablation (RFA) continues to have the most robust safety and efficacy data to support its use despite a relatively high rate of recurrence. Cryotherapy and Hybrid-APC appear to be safe and effective as RFA alternatives, but further trials are still needed to directly compare their outcomes to RFA and ultimately guide changes in treatment decisions.

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Section: Ablative Techniquesmentioning

confidence: 99%

Endoscopic therapies for Barrett’s esophagus

Ventre¹,

Shahid²

2021

Transl Gastroenterol Hepatol

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“…Bleeding (<1%) and perforation (<0.01%) are very rare with RFA alone, but can be more common when EMR is performed concurrently with RFA. No procedure-related deaths have been reported (52,53).…”

Section: Radiofrequency Ablation (Rfa)mentioning

confidence: 99%

“…Ps is the most commonly used sensitizer, and is typically given intravenously 2 days prior to the endoscopic procedure to allow time for adequate absorption into the tissue. Once the photosensitizer is activated by the laser light, a photodynamic reaction is initiated and free radicals are produced which lead to cell injury and apoptosis, with deeper tissue penetration compared to RFA or cryotherapy (52).…”

Section: Photodynamic Therapy (Pdt)mentioning

confidence: 99%

Barrett’s esophagus: best practices for treatment and post-treatment surveillance

Mansour

El–Serag

Anandasabapathy

2017

Ann. Cardiothorac. Surg.

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Barrett's esophagus (BE) is a premalignant condition that increases the risk of esophageal adenocarcinoma (EAC). Significantly more common in the Western world, risk factors include increased age, male sex, white race, gastro-esophageal reflux disease (GERD), central obesity, and cigarette smoking. The rates of progression to cancer depend on the grade of Barrett's dysplasia. Screening for BE is recommended in patients with GERD and additional risk factors. Endoscopic surveillance of patients with BE likely improves overall outcomes. Advanced endoscopic imaging can help increase the efficiency of current endoscopic surveillance.Endoscopic therapy is safe and effective for the treatment of dysplastic BE and intramucosal EAC, but ongoing surveillance following treatment is necessary. This review will cover screening, surveillance, advanced imaging, chemoprevention, endoscopic treatment, and post-treatment surveillance of BE.

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“…Currently, the most common application of MR is the endoscopic treatment of Barrett's esophagus, a precancerous condition, in which the normal squamous epithelium of the distal esophagus transforms to columnar-lined intestinal metaplasia. In this case, destruction of the mucosa by MR is subsequently followed by restoration of the squamous epithelium [10].…”

Section: Introductionmentioning

confidence: 98%

“…Contrary to situations, where the depth of ablation is insufficient, several conditions are requiring specifically superficial ablation, for example, benign mucosal conditions (e.g., postradiation proctitis and gastric antral vascular ectasia) [9] and Barrett´s esophagus, representing a common indication for RFA mucosal resurfacing (MR). Mucosal resurfacing involves the physical removal of superficial abnormal tissue followed by regrowth and restoration of normal tissue through a stem cell-mediated healing response [10]. Currently, the most common application of MR is the endoscopic treatment of Barrett's esophagus, a precancerous condition, in which the normal squamous epithelium of the distal esophagus transforms to columnar-lined intestinal metaplasia.…”

Section: Introductionmentioning

confidence: 99%

Development of Radiofrequency Ablation Generator and Balloon-Based Catheter for Microendoluminal Thin-Layer Ablation Therapy Using the Rat Duodenum as a Model of Low-Impedance Tissue

Nociarova

Novák

Polàk

et al. 2021

Journal of Healthcare Engineering

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Radiofrequency ablation (RFA) is a routinely used, safe, and effective method for the tissue destruction. Often, in case of its application in malignant conditions, the extent of tissue destruction is insufficient due to the size of the target lesion, as well as due to the risk of heat-induced damage to the surrounding organs. Nevertheless, there are conditions requiring superficial precise-depth ablation with preservation of deeper layers. These are represented, for example, by mucosal resurfacing in case of Barrett’s esophagus or treatment of recurrent mucosal bleeding in case of chronic radiation proctitis. Recently, new indications for intraluminal RFA use emerged, especially in the pancreatobiliary tract. In the case of intraductal use of RFA (e.g., biliary and pancreatic tract), there are currently available rigid and needle tip catheters. An expandable balloon-based RFA catheter suitable for use in such small-diameter tubular organs could be of benefit due to possible increase of contact between the probe and the target tissue; however, to prevent excessive tissue damage, a compatible generator suitable for low-impedance catheter/tissue is essential. This project aimed to develop a radiofrequency ablation generator and bipolar balloon-based catheter optimized for the application in the conditions of low-impedance tissue and (micro)endoluminal environment. Subsequent evaluation of biological effect in vivo was performed using duodenal mucosa in Wistar rat representing conditions of endoluminal radiofrequency ablation of low-impedance tissue. Experiments confirming the safety and feasibility of RFA with our prototype devices were conducted.

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Ablative Endoscopic Therapies for Barrett’s-Esophagus-Related Neoplasia

Cited by 14 publications

References 72 publications

Endoscopic therapies for Barrett’s esophagus

Endoscopic therapies for Barrett’s esophagus

Barrett’s esophagus: best practices for treatment and post-treatment surveillance

Development of Radiofrequency Ablation Generator and Balloon-Based Catheter for Microendoluminal Thin-Layer Ablation Therapy Using the Rat Duodenum as a Model of Low-Impedance Tissue

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