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Endoscopic resection in Barrett's esophagus

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https://www.readbyqxmd.com/read/28187035/hepatocyte-antigen-expression-in-barrett-esophagus-and-associated-neoplasia
#1
Sejal S Shah, Vishal S Chandan
Hepatocyte antigen or hepatocyte paraffin 1 (Hep Par 1) is widely used as a diagnostic immunomarker for hepatocellular carcinoma. It has also been identified as a rate-limiting enzyme of the urea cycle, carbamoyl phosphate synthetase 1. Hep Par 1 has been detected in non-neoplastic small intestinal epithelium, but its expression in Barrett esophagus and its related neoplasia has not been well investigated. We immunohistochemically evaluated expression of Hep Par 1 on 75 cases of Barrett esophagus (25 cases without dysplasia, 16 cases with low-grade dysplasia, 25 cases with high-grade dysplasia, and 9 cases with intramucosal adenocarcinoma) on endoscopic biopsies and endoscopic mucosal resections...
February 9, 2017: Applied Immunohistochemistry & Molecular Morphology: AIMM
https://www.readbyqxmd.com/read/28134635/efficacy-durability-and-safety-of-complete-endoscopic-mucosal-resection-of-barrett-esophagus-a-systematic-review-and-meta-analysis
#2
Yutaka Tomizawa, Vani J A Konda, Emmanuel Coronel, Christopher G Chapman, Uzma D Siddiqui
GOALS: To report the rate of eradication and recurrence of both neoplasia and intestinal mucosa and the rate of adverse events for complete endoscopic resection (CER) of Barrett esophagus (BE). BACKGROUND: There is limited composite data on the clinical efficacy of CER of BE with high-grade dysplasia or neoplasia. STUDY: We performed a systematic review and meta-analysis of cohort studies that reported the clinical outcome of patients with BE who underwent CER and had at least 15-month follow-up after the time of elimination of BE...
January 27, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28122386/endoscopic-management-of-barrett-s-esophagus-european-society-of-gastrointestinal-endoscopy-esge-position-statement
#3
Bas Weusten, Raf Bisschops, Emanuel Coron, Mário Dinis-Ribeiro, Jean-Marc Dumonceau, José-Miguel Esteban, Cesare Hassan, Oliver Pech, Alessandro Repici, Jacques Bergman, Massimiliano di Pietro
Current practices for the management of Barrett's esophagus (BE) vary across Europe, as several national European guidelines exist. This Position Statement from the European Society of Gastrointestinal Endoscopy (ESGE) is an attempt to homogenize recommendations and, hence, patient management according to the best scientific evidence and other considerations (e.g. health policy). A Working Group developed consensus statements, using the existing national guidelines as a starting point and considering new evidence in the literature...
February 2017: Endoscopy
https://www.readbyqxmd.com/read/28089434/gastroesophageal-reflux-disease-and-barrett-s-esophagus-after-laparoscopic-sleeve-gastrectomy-a-possible-underestimated-long-term-complication
#4
Alfredo Genco, Emanuele Soricelli, Giovanni Casella, Roberta Maselli, Lidia Castagneto-Gissey, Nicola Di Lorenzo, Nicola Basso
BACKGROUND: Morbidly obese patients are affected by gastroesophageal reflux disease (GERD) and hiatal hernia (HH) more frequently than lean patients. Because of conflicting results, the indication to sleeve gastrectomy (SG) in patients with GERD is still debated. OBJECTIVES: To evaluate the incidence of GERD on the basis of clinical, endoscopic, and histologic data in patients undergoing SG. SETTINGS: University hospital, Rome, Italy. METHODS: From July 2007 to January 2010, 162 patients underwent primary SG...
December 9, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28078459/endotherapy-in-case-of-relapse-of-neoplastic-barrett-s-esophagus-after-successful-initial-endoscopic-resection
#5
Sébastien Godat, Fabrice Caillol, Aurélie Autret, Erwan Bories, Christian Pesenti, Jean Philippe Ratone, Chiara De Cassan, Flora Poizat, Marc Giovannini
BACKGROUND: Endotherapy in cases of neoplastic Barrett esophagus (BE) relapse after successful initial endoscopic management is commonly accepted, but few studies analyze this topic and also take into account the metachronous lesions. AIMS: To evaluate the efficiency of endotherapy in the case of neoplastic BE relapse after successful complete endoscopic eradication of neoplastic BE and metaplastic BE. METHODS: Retrospective review of medical records was collected in a computerized and prospective manner between 2000 and 2015, in a single tertiary care center...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28042239/oral-steroid-prophylaxis-is-effective-in-preventing-esophageal-strictures-after-large-endoscopic-resection
#6
Jean-Philippe Ratone, Erwan Bories, Fabrice Caillol, Christian Pesenti, Sebastien Godat, Flora Poizat, Chiara De Cassan, Marc Giovannini
BACKGROUND: Strictures are frequent complications of large endoscopic mucosal resections (EMR) and endoscopic submucosal dissections of the esophagus. Local or systemic steroid therapy has shown promise in the prevention of secondary stenosis. The aim of this study was to evaluate the safety and efficacy of systemic steroid therapy following endoscopic resection of at least hemi-circumferential esophageal mucosa. METHODS: This was a single-center retrospective study in a tertiary center...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/27995191/non-radical-stepwise-complete-endoscopic-resection-of-barrett-s-epithelium-in-short-segment-barrett-s-esophagus-has-a-low-stricture-rate
#7
Andreas Koutsoumpas, Lai Mun Wang, Adam A Bailey, Richard Gillies, Robert Marshall, Michael Booth, Bruno Sgromo, Nick Maynard, Barbara Braden
Background and aims: Radical endoscopic excision of Barrett's epithelium performing 4 - 6 endoscopic resections during the same endoscopic session results in complete Barrett's eradication but has a high stricture rate (40 - 80 %). Therefore radiofrequency ablation is preferred after endoscopic mucosal resection (EMR) of visible nodules. We investigated the clinical outcome of non-radical, stepwise endoscopic mucosal resection with a maximum of two endoscopic resections per endoscopic session. Methods: We analysed our prospectively maintained database of patients undergoing esophageal EMR for early neoplasia in Barrett's esophagus from 2009 to 2014...
December 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27931632/complications-of-therapeutic-gastroscopy-colonoscopy-other-than-resection
#8
REVIEW
Zaheer Nabi
Gastrointestinal (GI) endoscopy is profoundly utilized for diagnostic and therapeutic purposes. The therapeutic potential of GI endoscopy has amplified many folds with the evolution of novel techniques as well as equipments. However, with the augmentation of therapeutic endoscopy, the extent, likelihood and severity of adverse events have increased as well. The attendant risks and adverse events with therapeutic endoscopy are many folds that of diagnostic endoscopy. Besides endoscopic resection, therapeutic endoscopy is widely utilized for hemostasis in GI bleeds, dilatation of stenosis, enteral stenting, foreign body removal, ablation of Barrett's esophagus etc...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27901624/endoscopic-mucosal-resection-for-barrett-s-esophagus
#9
Phillip S Ge, V Raman Muthusamy
Endoscopic mucosal resection (EMR) is an increasingly popular minimally invasive technique that is used for the management of superficial lesions in the upper and lower gastrointestinal tract. The goal of this article is to describe the indications and technique of EMR, with a focus on the endoscopic management of Barrett's esophagus (BE). The two major EMR techniques-cap EMR and band EMR-will be presented, along with a discussion of their efficacy as well as their integration into the broader treatment paradigm of endoscopic eradication therapy for BE...
November 30, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27889544/role-of-eus-in-patients-with-suspected-barrett-s-esophagus-with-high-grade-dysplasia-or-early-esophageal-adenocarcinoma-impact-on-endoscopic-therapy
#10
Michael J Bartel, Timothy M Wallace, Rene D Gomez-Esquivel, Massimo Raimondo, Herbert C Wolfsen, Timothy A Woodward, Michael B Wallace
BACKGROUND AND AIMS: Endoscopic therapy is the standard treatment for high-grade dysplasia and some cases of T1a esophageal adenocarcinoma (EAC), but it is not appropriate for deeply invasive disease. Data on the value of EUS for patient selection for endoscopic or surgical resection are conflicting. We investigated the outcome of esophageal EUS for the staging and treatment selection of patients with treatment-naive, premalignant Barrett's esophagus (BE) and suspected superficial EAC...
November 24, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27855466/detection-of-lesions-in-dysplastic-barrett-s-esophagus-by-community-and-expert-endoscopists
#11
Dirk W Schölvinck, Kim van der Meulen, Jacques J G H M Bergman, Bas L A M Weusten
Background and aims Endoscopic treatment of Barrett's esophagus (BE) consists of endoscopic resection of visible lesions followed by radiofrequency ablation (RFA) for any remaining flat BE. Because RFA is only justified in flat BE, detection of neoplastic lesions (high grade dysplasia [HGD] and early adenocarcinoma [EAC]) is crucial. We hypothesized that the detection of visible lesions containing HGD or EAC would be superior in BE expert centers compared with community hospitals, thereby supporting centralization of therapy for BE-related neoplasia...
February 2017: Endoscopy
https://www.readbyqxmd.com/read/27783167/clinicopathological-features-of-siewert-type-ii-adenocarcinoma-comparison-of-gastric-cardia-adenocarcinoma-and-barrett-s-esophageal-adenocarcinoma-following-endoscopic-submucosal-dissection
#12
Hiroki Osumi, Junko Fujisaki, Masami Omae, Tomoki Shimizu, Toshiyuki Yoshio, Akiyoshi Ishiyama, Toshiaki Hirasawa, Tomohiro Tsuchida, Yorimasa Yamamoto, Hiroshi Kawachi, Noriko Yamamoto, Masahiro Igarashi
OBJECTIVES: Siewert type II esophagogastric junction adenocarcinoma encompasses both gastric cardia adenocarcinoma (GCA) and Barrett's esophageal adenocarcinoma (BEA) due to short-segment Barrett's esophagus. We compared these two types of Siewert type II esophagogastric junction adenocarcinoma in terms of background factors and clinical outcomes of endoscopic submucosal dissection (ESD). METHODS: We enrolled 139 patients (142 lesions) who underwent ESD from 2006 to 2014 at our institution...
October 25, 2016: Gastric Cancer
https://www.readbyqxmd.com/read/27688205/endoscopic-submucosal-dissection-for-barrett-s-early-neoplasia-a-multicenter-study-in-the-united-states
#13
Dennis Yang, Roxana M Coman, Michel Kahaleh, Irving Waxman, Andrew Y Wang, Amrita Sethi, Ashish R Shah, Peter V Draganov
BACKGROUND AND AIMS: The role of endoscopic submucosal dissection (ESD) in Barrett's early neoplasia is not well defined, with most studies originating from Asia and Europe. We aimed to assess the efficacy, safety, and results of ESD in Barrett's esophagus (BE) with high-grade dysplasia (HGD) and early adenocarcinoma (EAC) across centers in the United States. METHODS: Multicenter retrospective analysis on 46 patients with BE who underwent ESD for BE-HGD or EAC, or both, between January 2010 and April 2015...
September 28, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27670227/efficacy-and-safety-outcomes-of-multimodal-endoscopic-eradication-therapy-in-barrett-s-esophagus-related-neoplasia-a%C3%A2-systematic-review-and-pooled-analysis
#14
REVIEW
Madhav Desai, Shreyas Saligram, Neil Gupta, Prashanth Vennalaganti, Ajay Bansal, Abhishek Choudhary, Sreekar Vennelaganti, Jianghua He, Mohammad Titi, Roberta Maselli, Bashar Qumseya, Mojtaba Olyaee, Irwing Waxman, Alessandro Repici, Cesare Hassan, Prateek Sharma
BACKGROUND AND AIMS: Focal EMR followed by radiofrequency ablation (f-EMR + RFA) and stepwise or complete EMR (s-EMR) are established strategies for eradication of Barrett's esophagus (BE)-related high-grade dysplasia (HGD) and/or esophageal adenocarcinoma (EAC)/intramucosal carcinoma (IMC). The objective of this study was to derive pooled rates of efficacy and safety of individual methods in a large cohort of patients with BE and to indirectly compare the 2 methods. METHODS: PubMed, Embase, Web of Science, Cochrane, and major conference proceedings were searched...
March 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27658906/identification-of-volumetric-laser-endomicroscopy-features-predictive-for-early-neoplasia-in-barrett-s-esophagus-using-high-quality-histological-correlation
#15
Anne-Fré Swager, Guillermo J Tearney, Cadman L Leggett, Martijn G H van Oijen, Sybren L Meijer, Bas L Weusten, Wouter L Curvers, Jacques J G H M Bergman
BACKGROUND AND AIMS: Volumetric laser endomicroscopy (VLE) provides a circumferential scan that enables visualization of the subsurface layers of the esophageal wall at 7 μm resolution. The aims of this study were to identify VLE features of Barrett's esophagus (BE) neoplasia and to develop a VLE prediction score. METHODS: A database of VLE images from endoscopic resection specimens, precisely correlated with histology, from patients with BE with and without neoplasia was used...
September 19, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27621766/endoscopic-applications-of-cryospray-ablation-therapy-from-barrett-s-esophagus-and-beyond
#16
REVIEW
Jayaprakash Sreenarasimhaiah
In the last decade, the treatment of dysplastic Barrett's esophagus has evolved into primarily endoscopic therapy. Many techniques have become well-established to destroy or remove the mucosal lining of Barrett's esophagus. One of the newest therapies, cryospray ablation, has become a modality to treat both dysplastic Barrett's esophagus as well as esophageal carcinoma. In endoscopic applications, the cryogen used is either liquid nitrogen or carbon dioxide which causes tissue destruction through rapid freeze-thaw cycles...
August 25, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27618753/esophageal-adenocarcinoma-screening-surveillance-and-management
#17
Nabil M Mansour, Shawn S Groth, Sharmila Anandasabapathy
Esophageal adenocarcinoma (EAC) is a growing problem with a rapidly rising incidence. Risk factors include gastroesophageal reflux disease, central obesity, and smoking. The prognosis of EAC remains poor because it is usually diagnosed late, and many efforts have been made to improve prevention, early detection, and treatment. Acid suppression, nonsteroidal antiinflammatory drugs (NSAIDs), and statins may play a role in chemoprevention. Screening for Barrett's esophagus (BE), the only known precursor lesion of EAC, is indicated for individuals with increased risk...
January 14, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/27573771/what-makes-an-expert-barrett-s-histopathologist
#18
REVIEW
Myrtle J van der Wel, Marnix Jansen, Michael Vieth, Sybren L Meijer
Clonal evolution to esophageal adenocarcinoma in Barrett's esophagus (BO) is characterized by relentless clonal competition. Developing markers that capture the dynamics of clonal competition in BO patients for risk stratification purposes is a key goal of translational research. Dysplastic epithelial changes in patients who progress to neoplasia can be viewed as a proxy marker of the clonal dynamics in BO progression. However, this marker is relatively insensitive because it does not pick up on clonal expansions that are not accompanied by morphologic changes...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27573768/diagnosis-by-endoscopy-and-advanced-imaging-of-barrett-s-neoplasia
#19
REVIEW
Anne-Fré Swager, Wouter L Curvers, Jacques J Bergman
Evaluation of patients with Barrett's esophagus (BE) using dye-based chromoendoscopy, optical chromoendoscopy, autofluorescence imaging, or confocal laser endomicroscopy does not significantly increase the number of patients with a diagnosis of early neoplasia compared with high-definition white light endoscopy (HD-WLE) with random biopsy analysis. These newer imaging techniques are not more effective in standard surveillance of patients with BE because the prevalence of early neoplasia is low and HD-WLE with random biopsy analysis detects most cases of neoplasia...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27556083/prospective-evaluation-of-the-clinical-utility-of-endoscopic-submucosal-dissection-esd-in-patients-with-barrett-s-esophagus-a-western-center-experience
#20
Roxana M Coman, Takuji Gotoda, Christopher E Forsmark, Peter V Draganov
BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) carries significant advantages over endoscopic mucosal resection. As such, ESD is an established therapy for esophageal squamous cell carcinoma but there are only limited data on ESD as therapy for Barrett's esophagus (BE). Thus, we prospectively evaluated the outcomes of ESD in patients with BE with high-grade dysplasia (HGD) and early esophageal adenocarcinoma (EAC) performed in a Western center. PATIENTS AND METHODS: This is a prospective cohort study...
June 2016: Endoscopy International Open
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