Role of Confocal Laser Endomicroscopy in Detection of Residual Barrett's Esophagus after Radiofrequency Ablation

Diamantis, G.; Buracco, Paolo; Realdon, Stefano; Battaglia, Giorgio

doi:10.1155/2011/593923

Cited by 3 publications

(2 citation statements)

References 24 publications

(22 reference statements)

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“…23 Another case report used eCLE to examine an area of the esophagus previously treated with radiofrequency ablation (RFA), identifying the neosquamous mucosa and the untreated area of residual BE. 24 In one series of patients with BE neoplasia, pCLE was performed before endoscopic therapy (EMR or RFA). 25 Of seven patients with BE neoplasia who underwent pCLE, pCLE confirmed the diagnosis of HGD suspected on narrow-band imaging (NBI) in three patients, and influenced the management of one patient by leading to additional EMRs for neoplasia.…”

Section: Assessing the Potential Impact Of Cle In Bementioning

confidence: 99%

Endomicroscopy in Barrett's Esophagus

Dunbar

2013

Gastrointestinal Endoscopy Clinics of North America

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Section: Assessing the Potential Impact Of Cle In Bementioning

confidence: 99%

Endomicroscopy in Barrett's Esophagus

Dunbar

2013

Gastrointestinal Endoscopy Clinics of North America

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“…Although the reported rates of subsquamous neoplasia after ablative therapy are low, optimal detection and delineation of recurrent neoplastic lesions requires careful observation during endoscopy and the use of enhanced imaging modalities such as high-resolution endoscopy, narrow-band imaging, and magnification endoscopy. Although recent studies have shown that endoscopy-or probe-based confocal laser endomicroscopy, and optical coherence tomography can be effective in identifying residual buried glands after RFA, the exact role of these technologies remain undefined [10,11]. In addition to better endoscopic detection, continued surveillance with biopsies of the neosquamous epithelium, even after successful eradication of intestinal metaplasia, is necessary.…”

Section: Case 4 !mentioning

confidence: 99%

Recurrence of subsquamous dysplasia and carcinoma after successful endoscopic and radiofrequency ablation therapy for dysplastic Barrett's esophagus

et al. 2013

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Barrett's esophagus with dysplasia is commonly treated with radiofrequency ablation (RFA). Despite its effectiveness, a concern of any ablative technique is the development of subsquamous intestinal metaplasia, which could have potential for future neoplastic progression. To date, 34 cases of subsquamous neoplasia have been described in the literature after various ablation therapies. However, only three cases of subsquamous neoplasia have been reported after successful RFA treatment of dysplastic Barrett's esophagus. In this case series, we report on four additional cases of subsquamous neoplasia detected after successful endoscopic resection and RFA for neoplastic and dysplastic Barrett's esophagus. All four patients were treated successfully with endoscopic resection of their recurrent subsquamous neoplastic and dysplastic lesions. This case series highlights the need for continued surveillance following successful treatment of dysplastic Barrett's esophagus with RFA.

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Post-ablation surveillance in Barrett's esophagus: A review of the literature

Stier¹,

Konda²,

Hart³

et al. 2016

WJG

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Barrett's esophagus (BE) is a pre-malignant condition affecting up to 15% of patients with gastroesophageal reflux disease. Neoplastic Barrett's mucosa is defined as harboring high grade dysplasia or intra-mucosal cancer, and carries a high risk of progression to esophageal adenocarcinoma. The rising incidence of Barrett's lesions along with the high morbidity of surgical approaches has led to the development of numerous validated endoscopic techniques capable of eradicating neoplastic mucosa in a minimally invasive manner. While there has been widespread adoption of these techniques, less is known about optimal surveillance intervals in the post-therapy period. This is due in part to limitations in current surveillance methods, questions about durability of treatment response and the risk of subendothelial progression. As we are now able to achieve organ sparing eradication of superficial neoplasia in BE, we need to also then focus our attention on how best to manage these patients after eradication is achieved. Implementing optimal surveillance practices requires additional understanding of the biology of the disease, appreciation of the limits of current tools and treatments, and exploration of the role of adjunctive technologies. The aim of this article is to provide a comprehensive review of current literature surrounding post-ablation surveillance in neoplastic BE.

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Role of Confocal Laser Endomicroscopy in Detection of Residual Barrett's Esophagus after Radiofrequency Ablation

Cited by 3 publications

References 24 publications

Endomicroscopy in Barrett's Esophagus

Endomicroscopy in Barrett's Esophagus

Recurrence of subsquamous dysplasia and carcinoma after successful endoscopic and radiofrequency ablation therapy for dysplastic Barrett's esophagus

Post-ablation surveillance in Barrett's esophagus: A review of the literature

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