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Endoscopic resection in Barrett's esophagus

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https://www.readbyqxmd.com/read/29129090/screening-and-prevention-strategies-and-endoscopic-management-of-early-esophageal-cancer
#1
James A Kim, Pari M Shah
Esophageal cancer is the 8th most common cancer worldwide and the 6th most common cause of cancer-related death. Its two main subtypes, esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC), have varying incidences globally, but recent decades have seen a demonstrated rise of EAC in Western countries whereas ESCC remains highly prevalent in Eastern Africa, Central Asia, and China. Screening interventions have focused on using endoscopy to identify Barrett's esophagus (BE) as a precursor to EAC, and squamous cell dysplasia prior to onset of ESCC...
October 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/29103533/diagnosis-and-management-of-barrett-related-neoplasia-in-the-modern-era
#2
REVIEW
Lysandra Voltaggio, Elizabeth A Montgomery
Whereas in the past, pathologists were hesitant to diagnose high-grade dysplasia in patients with Barrett esophagus, because this diagnosis prompted esophagectomy, current international consensus is that endoscopic treatment is the management for high-grade dysplasia and intramucosal carcinoma. Furthermore, many centers advocate endoscopic ablation for low-grade dysplasia. As such, establishing a diagnosis of dysplasia has become the key step; separation between the grades of dysplasia is less critical. This article offers some criteria for separating dysplasia from reactive changes, discusses pitfalls in interpreting endoscopic mucosal resection specimens, and outlines management strategies...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29078688/endoscopic-mucosal-ablation-and-resection-of-barrett-s-esophagus-and-related-diseases
#3
REVIEW
Juan A Muñoz-Largacha, Virginia R Litle
The prevalence of gastroesophageal reflux disease as well as the incidence of Barrett's esophagus (BE) has increased in the Western world over the last decades. The chronic reflux of gastric secretions injuries the esophageal mucosa and triggers cellular and molecular changes inducing the transformation of the normal squamous mucosa into columnar metaplastic epithelium. BE is a premalignant condition that can progress to low-grade dysplasia, high-grade dysplasia and ultimately esophageal adenocarcinoma. An early diagnosis of dysplastic changes and the adoption of appropriate therapeutic approaches are essential to improve patient outcomes and survival...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29065436/hot-avulsion-may-be-effective-as-salvage-treatment-for-focal-barrett-s-esophagus-remaining-after-endoscopic-therapy-for-dysplasia-or-early-cancer-a-preliminary-study
#4
Javier Aranda-Hernández, Yuto Shimamura, Andrea Grin, Yugo Iwaya, Maria Cirocco, Gabor Kandel, Gary May, Paul Kortan, Spiro Raftopoulos, Norman Marcon
Background and study aim Both endoscopic mucosal resection (EMR) and radiofrequency ablation (RFA) are used to treat Barrett's esophagus (BE) complicated by dysplasia and intramucosal cancer. However, focal areas of BE can remain after otherwise successful application of these techniques. We report the results of hot avulsion using a hot biopsy forceps to resect these residual focal areas. Patients and methods This was a retrospective study from a prospective database in a tertiary reference center from August 2013 to May 2015...
October 24, 2017: Endoscopy
https://www.readbyqxmd.com/read/29016405/definition-of-barrett-esophagus-in-the-united-states-support-for-retention-of-a-requirement-for-goblet-cells
#5
Kevan J Salimian, Kevin M Waters, Ogechukwu Eze, Maryam K Pezhouh, Yaman Tarabishy, Eun-Ji Shin, Marcia I Canto, Lysandra Voltaggio, Elizabeth A Montgomery
Barrett esophagus (BE) predisposes patients to the development of esophageal adenocarcinoma (EAC). However, the global definition of BE is controversial. Pathologists in Europe and the United States require intestinal metaplasia (IM) within columnar-lined mucosa (CLM) in the tubular esophagus to diagnose BE, whereas in the UK and Japan only the presence of CLM is required. To aid in establishing an appropriate definition for BE, we evaluated whether IM accompanies EAC in a US patient cohort. We examined a series of 139 consecutive patients who underwent endoscopic mucosal resections or esophagectomies for EAC performed at a US tertiary care center...
October 9, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28993137/endoscopic-submucosal-dissection-for-early-barrett-s-neoplasia-a-meta-analysis
#6
REVIEW
Dennis Yang, Fei Zou, Sican Xiong, Justin J Forde, Yu Wang, Peter V Draganov
BACKGROUND AND AIMS: The role of endoscopic submucosal dissection (ESD) in Barrett's esophagus (BE) is not well established. This meta-analysis aimed to evaluate the safety and efficacy of ESD for the management of early BE neoplasia. METHODS: Three online databases were searched. The Cochran Q test and I(2) were used to test for heterogeneity. Pooling was conducted using either fixed- or random-effects models depending on heterogeneity across studies. For the main outcomes, potential sources of heterogeneity were evaluated via linear regression analysis...
October 6, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28870046/-the-chinese-consensus-for-screening-diagnosis-and-management-of-barrett-s-esophagus-and-early-adenocarcinoma-2017-wanning
#7
(no author information available yet)
Patients with Barrett's esophagus (BE)/columnar lined esophagus (CLE) and adenocarcinoma are increasing, in whom 0.61% BE/CLE would develop to adenocarcinoma. The prognosis of esophageal cancer is related to the tumor stage at diagnosis. To standardize the screening, diagnosis and therapy of BE and adenocarcinoma in China, 31 digestive diseases and digestive endoscopy experts and digestive histologists drafted the consensus on the basis of clinical experience and references. The consensus defined BE as a complication of gastroesophageal reflux disease...
September 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28819902/ablation-therapy-for-barrett-s-esophagus-new-rules-for-changing-times
#8
REVIEW
Nour Hamade, Prateek Sharma
PURPOSE OF REVIEW: In this review, we discuss different endoscopic techniques in the eradication of Barrett's esophagus (BE) as well as some controversies in the field of treatment. RECENT FINDINGS: Patients with T1a esophageal adenocarcinoma and BE of high-grade dysplasia should undergo endoscopic ablative therapy. The most studied technique to date is radiofrequency ablation. It can be combined with endoscopic mucosal resection in cases containing nodular and flat lesions...
August 17, 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28816408/endoscopic-treatment-of-barrett-s-esophagus-what-can-we-learn-from-the-western-perspective
#9
REVIEW
Yuto Shimamura, Yugo Iwaya, Kenichi Goda, Christopher W Teshima
The incidence of Barrett's esophagus (BE)-related neoplasia in Western countries has increased in the past several decades and, even in Eastern countries, it appears to be increasing. Endoscopic therapies are the first-line treatment for BE-related neoplasia; however, there is still no standardized treatment strategy. Most of the data have been published from Western countries where the ultimate goal of treatment is complete eradication of BE mucosa removing subtle synchronous lesions and preventing metachronous neoplasia...
August 17, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28815063/the-impact-of-flexible-endoscopy-in-esophageal-surgery
#10
REVIEW
Alejandro Nieponice, Fabio Nachman, Adolfo Badaloni, Franco Ciotola, Cecilia Zubieta, Mauricio Ramirez
Achalasia and Treatment of esophageal Adenocarcinoma are commonly associated to surgical resection. Newer technologies in interventional endoscopy gave way to a substantial paradigm shift in the management of these conditions. In the case of achalasia, endoscopic myotomy is rapidly displacing Heller's myotomy as the gold standard in many centers. Early stage neoplasia in Barrett's esophagus (BE) comprising high-grade dysplasia (HGD), intramucosal and, in some cases, submucosal carcinoma is now being treated without the need of esophagectomy...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28791328/a-feasibility-study-of-photoacoustic-imaging-of-ex-vivo-endoscopic-mucosal-resection-tissues-from-barrett-s-esophagus-patients
#11
Liang Lim, Catherine J Streutker, Norman Marcon, Maria Cirocco, Alexandra Lao, Vladimir V Iakovlev, Ralph DaCosta, Brian C Wilson
BACKGROUND AND STUDY AIMS : Accurate endoscopic detection of dysplasia in patients with Barrett's esophagus (BE) remains a major clinical challenge. The current standard is to take multiple biopsies under endoscopic image guidance, but this leaves the majority of the tissue unsampled, leading to significant risk of missing dysplasia. Furthermore, determining whether there is submucosal invasion is essential for proper staging. Hence, there is a clinical need for a rapid in vivo wide-field imaging method to identify dysplasia in BE, with the capability of imaging beyond the mucosal layer...
August 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28770555/efficacy-of-liquid-nitrogen-cryotherapy-for-barrett-s-esophagus-after-endoscopic-resection-of-intramucosal-cancer-a-multicenter-study
#12
Arvind J Trindade, Douglas K Pleskow, Neil Sengupta, Shivangi Kothari, Sumant Inamdar, Joshua Berkowitz, Vivek Kaul
BACKGROUND AND AIM: Liquid nitrogen cryotherapy (LNC) allows increased depth of ablation compared to radiofrequency ablation (RFA) in Barrett's esophagus (BE). Expert centers may use LNC over RFA to ablate Barrett's esophagus after endoscopic resection of intramucosal cancer (IMCA). The aim of our study was to: 1) evaluate the safety and efficacy of LNC ablation in patients with BE and IMCA and 2) to evaluate the progression to invasive disease despite therapy. METHODS: This was a multicenter, retrospective study of consecutive patients with BE who received LNC following endoscopic mucosal resection (EMR) of IMCA...
August 2, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28720474/nitrous-oxide-cryotherapy-for-treatment-of-esophageal-squamous-cell-neoplasia-initial-multicenter-international-experience-with-a-novel-portable-cryoballoon-ablation-system-with-video
#13
Marcia Irene Canto, Julian A Abrams, Hannah T Künzli, Bas Weusten, Yoshihiro Komatsu, Blair A Jobe, Charles J Lightdale
BACKGROUND AND AIMS: Early esophageal squamous cell neoplasia (ESCN) can be successfully treated by EMR, endoscopic submucosal dissection (ESD), or radiofrequency ablation. A new portable, battery-powered cryotherapy system using nitrous oxide (cryoballoon focal ablation system [CbFAS]) has been used for Barrett's esophagus. It consists of a small hand-held device containing liquid nitrous oxide, which converts to gas within a low-pressure-compliant through-the-scope balloon and freezes targeted mucosa in contact with the balloon...
July 16, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28577773/esophagectomy-for-superficial-esophageal-neoplasia
#14
REVIEW
Thomas J Watson
Endoscopic therapies have become the standard of care for most cases of Barrett's esophagus with high-grade dysplasia or intramucosal adenocarcinoma. Despite a rapid and dramatic evolution in treatment paradigms, esophagectomy continues to occupy a place in the therapeutic armamentarium for superficial esophageal neoplasia. The managing physician must remain cognizant of the limitations of endoscopic approaches and consider surgical resection when they are exceeded. Esophagectomy, performed at experienced centers for appropriately selected patients with early-stage disease can be undertaken with the expectation of cure as well as low mortality, acceptable morbidity, and good long-term quality of life...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577770/radiofrequency-ablation-of-barrett-s-esophagus-efficacy-complications-and-durability
#15
REVIEW
Kavel Visrodia, Liam Zakko, Kenneth K Wang
In the last decade, radiofrequency ablation in combination with endoscopic mucosal resection has simplified and improved the treatment of Barrett's esophagus. These treatments not only reduced the progression of dysplastic Barrett's esophagus to esophageal adenocarcinoma but also decreased treatment-related complications. More recent data from larger series with extended follow-up periods are emerging to refine expectations in patients treated with radiofrequency ablation. Although most patients achieve eradication of neoplasia and intestinal metaplasia, in the long-term a substantial portion of patients develop recurrent disease...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577767/management-of-nodular-neoplasia-in-barrett-s-esophagus-endoscopic-mucosal-resection-and-endoscopic-submucosal-dissection
#16
REVIEW
Kamar Belghazi, Jacques J G H M Bergman, Roos E Pouw
Endoscopic resection has proven highly effective and safe in the removal of focal early neoplastic lesions in Barrett's esophagus and is considered the cornerstone of endoscopic treatment. Several techniques are available for endoscopic resection in Barrett's esophagus. The most widely used technique for piecemeal resection of early Barrett's neoplasia is the ligate-and-cut technique. Newer techniques such as endoscopic submucosal dissection may also play a role in the treatment of neoplastic Barrett's esophagus...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577765/the-role-of-adjunct-imaging-in-endoscopic-detection-of-dysplasia-in-barrett-s-esophagus
#17
REVIEW
Pujan Kandel, Michael B Wallace
Advances in imaging technologies have demonstrated promise in early detection of dysplasia and cancer in Barrett's esophagus (BE). Optical chromoendoscopy, dye-based chromoendoscopy, and novel technologies have provided the opportunity to visualize the cellular and subcellular structures. Only narrow-band imaging and acetic acid chromoendoscopy have reached benchmarks for clinical use. Volumetric laser endomicroscopy and molecular imaging are not established for routine use. Best practice in management of BE should be focused on careful endoscopic examination, resection, or ablation of the entire abnormal lesion, as well as the use of available imaging technique that has good diagnostic accuracy...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28576294/development-of-quality-indicators-for-endoscopic-eradication-therapies-in-barrett-s-esophagus-the-treat-be-treatment-with-resection-and-endoscopic-ablation-techniques-for-barrett-s-esophagus-consortium
#18
Sachin Wani, V Raman Muthusamy, Nicholas J Shaheen, Rena Yadlapati, Robert Wilson, Julian A Abrams, Jacques Bergman, Amitabh Chak, Kenneth Chang, Ananya Das, John Dumot, Steven A Edmundowicz, Glenn Eisen, Gary W Falk, M Brian Fennerty, Lauren Gerson, Gregory G Ginsberg, David Grande, Matt Hall, Ben Harnke, John Inadomi, Janusz Jankowski, Charles J Lightdale, Jitin Makker, Robert D Odze, Oliver Pech, Richard E Sampliner, Stuart Spechler, George Triadafilopoulos, Michael B Wallace, Kenneth Wang, Irving Waxman, Srinadh Komanduri
No abstract text is available yet for this article.
July 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28573176/recurrence-of-intestinal-metaplasia-and-early-neoplasia-after-endoscopic-eradication-therapy-for-barrett-s-esophagus-a-systematic-review-and-meta-analysis
#19
Larissa L Fujii-Lau, Birtukan Cinnor, Nicholas Shaheen, Srinivas Gaddam, Srinadh Komanduri, V Raman Muthusamy, Ananya Das, Robert Wilson, Violette C Simon, Vladimir Kushnir, Daniel Mullady, Steven A Edmundowicz, Dayna S Early, Sachin Wani
BACKGROUND:  Conflicting data exist with regard to recurrence rates of intestinal metaplasia (IM) and dysplasia after achieving complete eradication of intestinal metaplasia (CE-IM) in Barrett's esophagus (BE) patients. AIM:  (i) To determine the incidence of recurrent IM and dysplasia achieving CE-IM and (ii) to compare recurrence rates between treatment modalities [radiofrequency ablation (RFA) with or without endoscopic mucosal resection (EMR) vs stepwise complete EMR (SRER)]...
June 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28570552/development-of-quality-indicators-for-endoscopic-eradication-therapies-in-barrett-s-esophagus-the-treat-be-treatment-with-resection-and-endoscopic-ablation-techniques-for-barrett-s-esophagus-consortium
#20
REVIEW
Sachin Wani, V Raman Muthusamy, Nicholas J Shaheen, Rena Yadlapati, Robert Wilson, Julian A Abrams, Jacques Bergman, Amitabh Chak, Kenneth Chang, Ananya Das, John Dumot, Steven A Edmundowicz, Glenn Eisen, Gary W Falk, M Brian Fennerty, Lauren Gerson, Gregory G Ginsberg, David Grande, Matt Hall, Ben Harnke, John Inadomi, Janusz Jankowski, Charles J Lightdale, Jitin Makker, Robert D Odze, Oliver Pech, Richard E Sampliner, Stuart Spechler, George Triadafilopoulos, Michael B Wallace, Kenneth Wang, Irving Waxman, Srinadh Komanduri
No abstract text is available yet for this article.
July 2017: American Journal of Gastroenterology
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