New data on an old weapon: is argon plasma coagulation adequate treatment for dysplastic Barrett’s esophagus?

Shaheen, Nicholas J.

doi:10.1055/a-1230-5610

Cited by 3 publications

(5 citation statements)

References 15 publications

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“…Repeated treatment of the initial site might induce deep tissue injury (which increases the risk of stricturing) or transmural necrosis/perforation while undertreatment may result in incomplete eradication and the development of buried intestinal metaplasia. 68 Of note, the rate of stricture formation with these modalities is not insignificant, between 4% and 9%, and increases the overall number of endoscopic procedures. 69 – 72 As such, experts typically limit the use of these modalities to patients with a small burden of BE, typically in the form of widely scattered islands.…”

Section: Eet and Patient Selectionmentioning

confidence: 97%

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The evolution of endoscopic therapy for Barrett’s esophagus

Condon

Muthusamy

2021

Clin Med Insights Gastroenterol

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Barrett’s esophagus is the condition in which a metaplastic columnar epithelium replaces the stratified squamous epithelium that normally lines the distal esophagus. The condition develops as a consequence of chronic gastroesophageal reflux disease and predisposes the patient to the development of esophageal adenocarcinoma. The diagnosis and management of Barrett’s esophagus have undergone dramatic changes over the years and continue to evolve today. Endoscopic eradication therapy has revolutionized the management of dysplastic Barrett’s esophagus and early esophageal adenocarcinoma by significantly reducing the morbidity and mortality associated with the prior gold standard of therapy, esophagectomy. The purpose of this review is to highlight current principles in the management and endoscopic treatment of this disease.

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Section: Eet and Patient Selectionmentioning

confidence: 97%

“… 69 – 72 As such, experts typically limit the use of these modalities to patients with a small burden of BE, typically in the form of widely scattered islands. 68 …”

Section: Eet and Patient Selectionmentioning

confidence: 99%

The evolution of endoscopic therapy for Barrett’s esophagus

Condon

Muthusamy

2021

Clin Med Insights Gastroenterol

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“…On the contrary, the energy delivered tends to be higher at the initial site of treatment and lower as the probe is moved along the BE tract. The exaggerated amount of energy conveyed to the initial site can lead to potential deep tissue injury, whereas a scarce delivery can result in an unsuccessful treatment with persistence of buried BE glands under the neo-squamous epithelium [46]. Indeed, a high rate of recurrence of both metaplasia and dysplasia in more than one third of treated patients was reported at long-term follow-up with a 3% annual risk of developing EAC, which is comparable to the risk of those BE patients who did not undergo ablative therapy [47].…”

Section: Argon Plasma Coagulationmentioning

confidence: 99%

What Is “Cold” and What Is “Hot” in Mucosal Ablation for Barrett’s Oesophagus-Related Dysplasia: A Practical Guide

Spadaccini

Alfarone

Chandrasekar

et al. 2023

Life

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Over the last two decades, endoscopic eradication therapy has been established as the therapeutic strategy of choice for patients with Barrett’s oesophagus-related dysplasia and early oesophageal adenocarcinoma. With a multimodal approach, ablative therapies have been highly effective in achieving remarkable eradication rates of metaplastic epithelium with an acceptable adverse event rate. Among ablative techniques, radiofrequency ablation is currently considered as the first-line option as its efficacy and safety are strongly supported by relevant data. Nevertheless, radiofrequency ablation is costly, and not universally available, or applicable to every situation. Moreover, primary failure and recurrence rates are not negligible. In the last few years, cryotherapy techniques and hybrid argon plasma coagulation have been increasingly assessed as potential novel ablative therapies. Preliminary data have been promising and suggest that they may even have a role as first-line options, alternatively to radiofrequency ablation. The aim of this review is to provide a practical guide for the ablation of Barrett’s oesophagus, with emphasis on the different ablative options.

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“…Для эндоскопического лечения пищевода Барретта все чаще используются технологии на базе современной науки: аргон-плазменная коагуляция (АПК), ультразвуковая деструкция, лазерная и фотодинамическая терапия, радиочастотная и криоабляция, эндоскопическая резекция слизистой оболочки. Аргон-плазменная коагуляция считается одним из самых безопасных и результативных методов с минимальными побочными эффектами и осложнениями [10][11][12].…”

Section: результаты и обсуждениеunclassified

“…Комплексный подход в лечении пациентов ГЭРБ, осложненной метаплазией СОП, помогает добиться хороших результатов лечения, что отражено в ряде публикаций других авторов [11,12].…”

Section: результаты и обсуждениеunclassified

Complex approach in diagnostics and treatment of gastroesophageal reflux disease complicated by metaplasia of the esophagus

Cherkasov¹,

Cherkasov²,

Гаджиевна³

et al. 2022

Medical news of the North Caucasus

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rostov state medical university, rostov-on-Don, russian federationПроанализированы результаты лечения 34 пациентов с гастроэзофагеальной рефлюксной болезнью (ГЭРБ), осложненной метаплазией слизистой оболочки пищевода. У 19 (55,9 %) пациентов выявлена кишечная метаплазия, у 9 (26,5 %) -желудочная метаплазия, в 6 случаях -дисплазия низкой степени на фоне кишечной (4) и желудочной (2) метаплазии. После верификации диагноза, консервативной терапии и антирефлюксной операции выполнялась аргон-плазменная коагуляция в зависимости от максимальной длины циркулярного сегмента метаплазии. Осложнений, связанных с процедурой, отмечено не было. В отдаленном периоде у всех пациентов отмечалась регенерация участков метаплазии здоровой тканью. За 6 лет наблюдений ни у одного больного не выявлено рецидивов. Основой успешного лечения ГЭРБ, осложненной метаплазией слизистой оболочки пищевода, является комплексный подход, а разработанная методика аргон-плазменной коагуляции позволяет избежать стриктур пищевода и добиться регресса метаплазии. Ключевые слова: гастроэзофагельная рефлюксная болезнь, рефлюкс-эзофагит, метаплазия пищевода, пищевод БарреттаThe treatment results of 34 patients with GERD complicated by metaplasia of the esophageal mucosa were analyzed. According to the pathomorphological conclusion, 19 (55.9 %) had intestinal metaplasia, in 9 (26.5 %) founded gastric metaplasia, in the remaining 6 cases -low-grade dysplasia against the background of intestinal (4) and gastric (2) metaplasia. After provided diagnosis verification, conservative therapy and antireflux surgery, the patient underwent argon-plasma coagulation, depended from the maximum length of the circular segment of metaplasia. There were no complications, associated with argon-plasma coagulation procedures. In the long-term period, all patients showed regeneration of metaplasia areas with healthy tissue. In observation during 6 years, there were no patient had a relapse of the disease. The basis for the successful treatment is an integrated approach, and the developed technique of argon-plasma coagulation, that allows to avoid the esophageal strictures and to achieve the regression of metaplasia of the esophageal mucosa.

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New data on an old weapon: is argon plasma coagulation adequate treatment for dysplastic Barrett’s esophagus?

Abstract: The publisher announces that this article has been temporarily removed. An edited version will be published under the same DOI as soon as possible. We thank you for your understanding. If you have any questions, please contact am-query@thieme.com.

Cited by 3 publications

References 15 publications

The evolution of endoscopic therapy for Barrett’s esophagus

The evolution of endoscopic therapy for Barrett’s esophagus

What Is “Cold” and What Is “Hot” in Mucosal Ablation for Barrett’s Oesophagus-Related Dysplasia: A Practical Guide

Complex approach in diagnostics and treatment of gastroesophageal reflux disease complicated by metaplasia of the esophagus

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