Endoscopic Therapy of Barrett Esophagus

Gaddam, Srinivas; Wani, Sachin

doi:10.1016/j.giec.2012.10.001

Cited by 6 publications

(3 citation statements)

References 109 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, stricture was far more common in the SRER group (88% versus 14%, P < 0.001) and this resulted in substantially more therapeutic sessions per patient in the SRER group (six versus three, P < 0.001) . Based on these data, as well as multiple studies demonstrating good long‐term outcomes in patients treated with focal ER followed by ablation of residual BE, most experts currently recommend ablation rather than SRER after ER of visible lesions …”

Section: Combination Of Endoscopic Eradication Therapy For Barrett's mentioning

confidence: 99%

Can endoscopic resection for Barrett's dysplasia and early cancer be curative?

Friedland

Triadafilopoulos

2018

Annals of the New York Academy of Sciences

View full text Add to dashboard Cite

Effective endoscopic treatments for dysplasia and early (intramucosal) cancer, together with expanded and rigorous screening programs to detect Barrett's esophagus, could help reverse the increase in the incidence of esophageal cancer and reduce esophageal cancer-related mortality. In this review, we discuss the long-term outcomes for mucosal resection for dysplasia and early cancer and compares them to esophagectomy as the standard of care choice. Eendoscopic resection for Barrett's dysplasia and early cancer can be curative but only when the lesion can be classified as: Paris type I (polypoid); Paris IIa (slightly elevated); Paris IIb (flat); Paris IIc (slightly depressed); histological grades G1 and G2; high-grade dysplasia. The size of the lesion is important, since <20 mm diameter lesions can be removed using endoscopic mucosal resection or, if they are larger, by endoscopic submucosal dissection. Proper imaging and lesion characterization followed by endoscopic resection as needed are essential in diagnostic and therapeutic decision making. Mucosal (T1a) Barrett's cancer and low-risk submucosal cancers have a minimal risk for lymph node metastasis and local endoscopic treatment is justified. Long-term outcomes of endoscopic therapy are same as surgery.

show abstract

Section: Combination Of Endoscopic Eradication Therapy For Barrett's mentioning

confidence: 99%

Can endoscopic resection for Barrett's dysplasia and early cancer be curative?

Friedland

Triadafilopoulos

2018

Annals of the New York Academy of Sciences

View full text Add to dashboard Cite

show abstract

“…A concerning report from the Netherlands suggests that non-expert endoscopists often fail to appreciate visible lesions in BE: 76% of patients referred to a Barrett's treatment center after "random" surveillance biopsies demonstrated dysplasia had a visible lesion on repeat endoscopy (28). After ER of visible dysplasia, ablation to eliminate the remaining metaplasia is recommended to reduce the risk of metachronous dysplasia and cancer (29). In a UK registry study of 335 patients with BE and early neoplasia, nodules were removed by ER, and patients underwent RFA every 3 months.…”

Section: Hgd and Imcmentioning

confidence: 99%

Precision care for Barrett’s esophagus

Triadafilopoulos¹,

Friedland²

2018

Transl. Gastroenterol. Hepatol

View full text Add to dashboard Cite

Modern recognition and management of Barrett's esophagus, a precursor to esophageal adenocarcinoma depends on diagnostic accuracy, risk assessment, technical expertise and consideration of many options to best tailor therapy for every patient. Concomitant management of acid reflux is essential, frequently with proton pump inhibitors. Ablation and resection favorably affect the evolution towards cancer. Using precision medicine tools, such as imaging, molecular diagnostics and analytics may lead to cost-and comparatively-effective therapies ultimately aiming at cancer prevention. Knowledge of the risk factors for Barrett's esophagus and progression to dysplasia and cancer can help tailor a precision medicine approach with more aggressive screening and surveillance targeted at patients that are most likely to benefit.

show abstract

“…Para la metaplasia aislada la endoscopia con biopsias es recomendable cada 2 a 3 años, para la displasia de bajo grado cada año y para la de alto grado cada 3 a 6 meses (25). Sin embargo, diferentes autores proponen la remoción quirúrgica en los casos de displasia de bajo o de alto grado, aunque el refi namiento y desarrollo de las técnicas de terapia endoscópica han logrado impactar favorablemente el problema (26)(27)(28). La RFA es uno de los métodos más recientemente descrito para el manejo del EB.…”

Section: A a B B C C D D E E F Funclassified

Ablación con radiofrecuencia del esófago de Barret con displasia o carcinoma in situ. Experiencia preliminar

Castaño

Álvarez²,

Piñeres³

et al. 2014

Rev Colomb Gastroenterol

View full text Add to dashboard Cite

Introducción: el esófago de Barrett (EB) es el resultado de la injuria crónica del ácido sobre el epitelio esofágico por el RGE. Se define cuando el epitelio metaplásico columnar reemplaza al epitelio escamoso estratificado que normalmente recubre el esófago. El EB representa un factor de riesgo para el adenocarcinoma de esófago. El objetivo de la ablación por radiofrecuencia (RFA) es destruir el epitelio metaplásico con la corriente eléctrica de radiofrecuencia para estimular la reaparición del epitelio plano estratificado del esófago distal. Objetivo: evaluar la eficiencia y seguridad de la técnica de RFA, recientemente introducida en la ciudad de Medellín, Colombia, para el manejo del EB con displasia o carcinoma in situ. Materiales y métodos: diez pacientes fueron tratados con RFA. Pacientes con EB con displasia o carcinoma in situ como hallazgo histológico fueron elegidos para el tratamiento. La técnica de RFA se aplicó usando el equipo BARRX: el sistema circular HALO360 o el HALO90. Los efectos macro o microscópicos de la terapia con RFA, la tolerancia del paciente al tratamiento así como las complicaciones fueron evaluadas. Resultados: un grupo de 10 pacientes recibió la terapia con RFA, todos terminaron la terapia y el seguimiento. En siete pacientes había displasia de bajo grado, en dos de alto grado y un paciente con carcinoma in situ. Dos pacientes tenían resección endoscópica con bandas de nódulos de la mucosa previa a la terapia con RFA. Se realizaron un total de 13 procedimientos: 10 con HALO360, 2 HALO90 y un paciente tratado con argón plasma para un EB residual. En todos los pacientes se logró la erradicación del epitelio esofágico metaplásico y displásico como se confirmó en la evaluación endoscópica e histológica. No se encontraron complicaciones significativas relacionadas con la terapia de RFA, pero en dos pacientes se encontró estenosis del esófago y uno requirió dilataciones endoscópicas tres semanas después de la terapia. Conclusiones: con base en estos resultados preliminares consideramos que este es un método promisorio, sin mayores complicaciones y bien tolerado por el paciente. En la mayoría de pacientes se erradicó exitosamente el epitelio metaplásico y displásico del esófago distal.

show abstract

Endoscopic Therapy of Barrett Esophagus

Cited by 6 publications

References 109 publications

Can endoscopic resection for Barrett's dysplasia and early cancer be curative?

Can endoscopic resection for Barrett's dysplasia and early cancer be curative?

Precision care for Barrett’s esophagus

Ablación con radiofrecuencia del esófago de Barret con displasia o carcinoma in situ. Experiencia preliminar

Contact Info

Product

Resources

About