Cryoablation of Barrett's esophagus: a pilot study

Johnston, Mark; Eastone, John A.; Horwhat, John D.; Cartledge, Jennifer; Mathews, Janice S.; Foggy, Jacinda R.

doi:10.1016/j.gie.2005.05.008

Cited by 167 publications

(110 citation statements)

References 24 publications

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“…Though infrequent, stricture formation and esophageal perforation have been reported (FDA Maude database). Endoscopic application of cryotherapy has also been reported to eliminate Barrett's esophagus, although there is very limited data about its efficacy (51).…”

Section: The Management Of Dysplasiamentioning

confidence: 99%

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Sampliner

2008

The American Journal of Gastroenterology

1,277

893

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PREAMBLEThe guidelines for the diagnosis, surveillance and therapy of Barrett's esophagus were originally published by the American College of Gastroenterology in 1998 and updated in 2002. These and other guidelines undergo periodic review. Significant advances have occurred in the area of Barrett's esophagus over the past four years leading to another revision of the prior guidelines. These advances include the potential use of esophageal capsule endoscopy for the diagnosis and screening of Barrett's esophagus, data regarding the outcome of low-grade dysplasia, the treatment of high-grade dysplasia using photodynamic therapy, and the development of new ablation techniques such as radiofrequency ablation. These guidelines are intended to be applied by physicians who see Barrett's esophagus patients and are intended to indicate a preferred, but certainly not the only, acceptable approach. Physicians need to choose the course best suited to the individual patient and to the variables that exist at the time of decision making. The guidelines are for adult patients with the diagnosis of Barrett's esophagus, as defined herein.Both these and the original guidelines were developed under auspices of the American College of Gastroenterology and the Practice Parameters Committee and approved by the Board of Trustees. The world literature was reviewed extensively for the original guidelines and once again reviewed using the National Library of Medicine database. Search terms used included Barrett's esophagus, esophageal neoplasm, esophagus, intestinal metaplasia, esophageal diseases, and adenocarcinoma, all appropriate studies and any additional ones found in reference to these papers were obtained and reviewed. Evidence was available from a hierarchy of trials and randomized controlled trials were given the greatest weight. Abstracts presented at national and international meetings were only used when unique data from ongoing trials were presented. When scientific data were lacking, recommendations are based on expert opinion. The recommendations made are based on the level of evidence found. Grade A recommendations imply that there is consistent level 1 evidence (randomized controlled trials), Grade B indicates that the evidence would be level 2 or 3 which are cohort studies or case control studies. Grade C recommendations are based on level 4 studies meaning case series or poor quality cohort studies, and Grade D recommendations are based on level 5 evidence meaning expert opinion.

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Section: The Management Of Dysplasiamentioning

confidence: 99%

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Sampliner

2008

The American Journal of Gastroenterology

1,277

893

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“…At the time of their 2005 pilot study, the only other endoscopic ablative method that was FDA approved for the treatment of high-grade dysplasia in Barrett's esophagus was photodynamic therapy. The authors were able to show in a series of 11 patients that the use of SCT for the ablation of high-grade dysplasia in Barrett's esophagus was efficacious, safe and easy to perform (11 (12,13).…”

Section: Brief History Of Cryotherapymentioning

confidence: 99%

Current status of spray cryotherapy for airway disease

Moore¹,

Lile²,

Abbas³

2017

J. Thorac. Dis.

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The use of liquid nitrogen to treat skin and mucosal lesions is well understood in the dermatologic and gastrointestinal literature. Direct spray cryotherapy (SCT) in the airway has shown promising results in the treatment of esophageal premalignant and even invasive lesions. In the airway, several studies have shown it to be a safe, effective treatment for both benign and malignant disease. It is easily administered in the outpatient setting and can be repeated several times without undue side effects. In this article, we review the current literature on the use of SCT for the treatment of endobronchial lesions and also describe our own institutional experience of the use of SCT in the airway. The use of proper technique and airway venting is important in mitigating the complications of barotrauma from massive expansion of nitrogen upon conversion from the liquid to gaseous state. We also review some of the basic science principals behind the use of the cryotherapy to treat lesions in different tissues. We feel that SCT is a potential area for further research at both clinical and basic science level.

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“…Whether ablation therapy eliminates or significantly reduces the risk of cancer, eliminates the need for surveillance endoscopy, or is cost-effective, also remains to be seen. Comparative trials that are now underway should help to answer these questions (35). Hubbard and Velanovich stated that endoscopic endoluminal RFA using the Barrx device (Barrx Medical, Sunnyvale, CA) is a new technique to treat BE.…”

Section: Rfa In Management Of Barrett's Esophagusmentioning

confidence: 99%