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Endoscopic resection in Barrett's esophagus

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https://www.readbyqxmd.com/read/29777441/mucosal-ablation-in-patients-with-barrett-s-esophagus-fry-or-freeze
#1
REVIEW
Kavel Visrodia, Liam Zakko, Kenneth K Wang
The management of Barrett's esophagus and early esophageal adenocarcinoma has shifted away from esophagectomy and toward endoscopic techniques, including endoscopic resection and ablative therapies. The most commonly used ablative therapies are radiofrequency ablation and cryotherapy. Radiofrequency ablation has risen to the top of the management algorithm due to its favorable safety profile and established track record of efficacy in patients with dysplastic Barrett's. Cryotherapy offers early promise as an alternatively safe and effective ablative modality...
May 17, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29768079/the-spectrum-of-surgical-remediation-of-transoral-incisionless-fundoplication-related-failures
#2
Ruchir Puri, C Daniel Smith, Steven P Bowers
AIM: To evaluate outcomes of surgical remediation for symptomatic or anatomic failure after a transoral incisionless fundoplication (TIF). METHODS: This retrospective study was performed on 11 patients who underwent a remedial operation following TIF failure between June 2011 and September 2016 at the Mayo Clinic in Florida for persistent foregut symptoms. Upper gastrointestinal workup characterized 1 patient as having normal post-TIF anatomy and 10 as having anatomic failure...
May 16, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29752721/can-endoscopic-resection-for-barrett-s-dysplasia-and-early-cancer-be-curative
#3
REVIEW
Shai Friedland, George Triadafilopoulos
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...
May 11, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29720850/diagnosis-and-treatment-of-superficial-esophageal-cancer
#4
REVIEW
Maximilien Barret, Frédéric Prat
Endoscopy allows for the screening, early diagnosis, treatment and follow up of superficial esophageal cancer. Endoscopic submucosal dissection has become the gold standard for the resection of superficial squamous cell neoplasia. Combinations of endoscopic mucosal resection and radiofrequency ablation are the mainstay of the management of Barrett's associated neoplasia. However, protruded, non-lifting or large lesions may be better managed by endoscopic submucosal dissection. Novel ablation tools, such as argon plasma coagulation with submucosal lifting and cryoablation balloons, are being developed for the treatment of residual Barrett's esophagus, since iatrogenic strictures still hamper the development of extensive circumferential resections in the esophagus...
May 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29655833/development-of-evidence-based-surveillance-intervals-following-radiofrequency-ablation-of-barrett-s-esophagus
#5
Cary C Cotton, Rehan Haidry, Aaron P Thrift, Laurence Lovat, Nicholas J Shaheen
BACKGROUND AND AIMS: Barrett's esophagus (BE) recurs in 25% or more of patients treated successfully with radiofrequency ablation (RFA), so surveillance endoscopy is recommended after complete eradication of intestinal metaplasia (CEIM). The frequency of surveillance is informed only by expert opinion. We aimed to model the incidence of neoplastic recurrence, validate the model in an independent cohort, and propose evidence-based surveillance intervals. METHODS: We collected data from the United States Radiofrequency Ablation Registry (US RFA, 2004-2013) and the United Kingdom National Halo Registry (UK NHR, 2007-2015) to build and validate models to predict the incidence of neoplasia recurrence following initially successful RFA...
April 12, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29607393/accuracy-of-probe-based-confocal-laser-endomicroscopy-pcle-compared-to-random-biopsies-during-endoscopic-surveillance-of-barrett-s-esophagus
#6
Tilak Shah, Robert Lippman, Divyanshoo Kohli, Pritesh Mutha, Sanjeev Solomon, Alvin Zfass
Background:  For surveillance of Barrett's esophagus (BE), the current standard of random 4-quadrant biopsies misses 10 - 50 % of esophageal neoplasms, and does not permit real-time decision-making. Probe-based confocal laser endomicroscopy (pCLE) permits real-time in vivo histologic assessment of esophageal mucosa during upper endoscopy. Prospective studies comparing the accuracy of pCLE to 4-quadrant biopsies in routine clinical practice are lacking. Methods:  Consecutive patients with BE underwent high definition white light and narrow-band imaging followed by pCLE and targeted biopsy or mucosal resection...
April 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29539629/treatment-outcomes-of-endoscopic-submucosal-dissection-for-adenocarcinoma-originating-from-long-segment-barrett-s-esophagus-versus-short-segment-barrett-s-esophagus
#7
Tomoki Shimizu, Junko Fujisaki, Masami Omae, Akira Yamasaki, Yusuke Horiuchi, Akiyoshi Ishiyama, Toshiyuki Yoshio, Toshiaki Hirasawa, Yorimasa Yamamoto, Tomohiro Tsuchida
BACKGROUND: In recent years, effective outcomes of endoscopic submucosal dissection (ESD) for esophagogastric junction cancer including short-segment Barrett's esophagus (SSBE) cancer have been reported. However, the efficacy of ESD for long-segment Barrett's esophagus (LSBE) cancer is unknown. AIM: To clarify the treatment outcomes of ESD for LSBE cancer versus SSBE cancer. METHODS: A total of 86 patients with 91 superficial Barrett's esophageal adenocarcinomas who underwent ESD were enrolled; of these, 68 had underlying SSBE and 18 had LSBE...
2018: Digestion
https://www.readbyqxmd.com/read/29536160/prognosis-of-patients-with-superficial-t1-esophageal-cancer-who-underwent-endoscopic-resection-before-esophagectomy-a-propensity-score-matched-comparison
#8
Patrick Sven Plum, Arnulf Heinrich Hölscher, Kristin Pacheco Godoy, Henner Schmidt, Felix Berlth, Seung-Hun Chon, Hakan Alakus, Elfriede Bollschweiler
BACKGROUND: The aim of this retrospective study was to compare the prognosis of patients with esophageal cancer after non-curative endoscopic resection (ER) followed by esophagectomy (ER + S) with that of patients after primary surgery (PS). METHODS: Between 2000 and 2015, 287 patients had esophagectomy for T1 esophageal cancer. 81 of these patients underwent at least one ER in curative intention before surgery (7 squamous cell carcinomas, 74 adenocarcinomas)...
March 13, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29524114/cryotherapy-and-radiofrequency-ablation-for-eradication-of-barrett-s-esophagus-with-dysplasia-or-intramucosal-cancer
#9
Prashanthi N Thota, Zubin Arora, John A Dumot, Gary Falk, Tanmayee Benjamin, John Goldblum, Sunguk Jang, Rocio Lopez, John J Vargo
BACKGROUND AND AIMS: Endoscopic ablation therapy has become the mainstay of treatment of Barrett's associated dysplasia and intramucosal cancer (IMC). The widely available techniques for ablation are radiofrequency ablation (RFA) and cryotherapy. Our aim was to compare eradication rates of metaplasia and dysplasia with both these modalities. PATIENTS AND METHODS: Retrospective review of prospectively collected database of patients who underwent endoscopic therapy for Barrett's dysplasia or IMC from 2006 to 2011 was performed...
May 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29458152/controversies-in-endoscopic-eradication-therapy-for-barrett-s-esophagus
#10
Srinadh Komanduri, V Raman Muthusamy, Sachin Wani
Advances in endoscopic eradication therapy for Barrett's Esophagus-associated neoplasia have resulted in a significant paradigm shift in the diagnosis and management of this complex disease. A robust body of literature critically evaluating outcomes of resection and ablative strategies has allowed gastroenterologists to make quality, evidence-based decisions for their patients. Despite this progress, there are still many unanswered questions and challenges that remain. Ultimately, identification of a cost-effective screening modality, biomarkers for risk stratification, and strides to eliminate post surveillance endoscopy after endoscopic eradication therapy are essential to reach our long-term goal for eradication of esophageal adenocarcinoma...
May 2018: Gastroenterology
https://www.readbyqxmd.com/read/29435819/expanding-role-of-third-space-endoscopy-in-the-management-of-esophageal-diseases
#11
REVIEW
Dennis Yang, Peter V Draganov
OPINION STATEMENT: "Third space" endoscopy, also commonly referred as submucosal endoscopy, is founded on the principle that the deeper layers of the gastrointestinal (GI) tract can be accessed by tunneling in the submucosal space without compromising the integrity of the overlying mucosa. Peroral endoscopic myotomy (POEM), endoscopic submucosal dissection (ESD), and submucosal tunneling endoscopic resection (STER) are innovative techniques within the field of third space endoscopy in the management of esophageal disorders...
March 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29351773/treatment-of-long-segment-barrett-s-adenocarcinoma-by-complete-circular-endoscopic-submucosal-dissection-a-case-report
#12
Miki Kaneko, Akira Mitoro, Motoyuki Yoshida, Masayoshi Sawai, Yasushi Okura, Masanori Furukawa, Tadashi Namisaki, Kei Moriya, Takemi Akahane, Hideto Kawaratani, Mitsuteru Kitade, Kousuke Kaji, Hiroaki Takaya, Yasuhiko Sawada, Kenichiro Seki, Shinya Sato, Tomomi Fujii, Junichi Yamao, Chiho Obayashi, Hitoshi Yoshiji
BACKGROUND: We present the first description of en bloc endoscopic submucosal dissection (ESD) for total circumferential Barrett's adenocarcinoma, predominantly of the long-segment Barrett's esophagus (LSBE), with a 2-year follow-up and management strategies for esophageal stricture prevention. CASE PRESENTATION: A 59-year-old man was diagnosed with LSBE and Barrett's adenocarcinoma by esophagogastroduodenoscopy (EGD). A 55-mm-long circumferential tumor was completely resected by ESD...
January 19, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29342490/detection-of-early-neoplasia-in-barrett-s-esophagus-using-lectin-based-near-infrared-imaging-an-ex-vivo-study-on-human-tissue
#13
André A Neves, Massimiliano Di Pietro, Maria O'Donovan, Dale J Waterhouse, Sarah E Bohndiek, Kevin M Brindle, Rebecca C Fitzgerald
BACKGROUND AND STUDY AIMS:  Endoscopic surveillance for Barrett's esophagus (BE) is limited by long procedure times and sampling error. Near-infrared (NIR) fluorescence imaging minimizes tissue autofluorescence and optical scattering. We assessed the feasibility of a topically applied NIR dye-labeled lectin for the detection of early neoplasia in BE in an ex vivo setting. METHODS:  Consecutive patients undergoing endoscopic mucosal resection (EMR) for BE-related early neoplasia were recruited...
January 17, 2018: Endoscopy
https://www.readbyqxmd.com/read/29250106/update-on-the-management-of-barrett-s-esophagus-in-austria
#14
M Riegler, I Kristo, M Nikolic, E Rieder, S F Schoppmann
Background: Barrett's esophagus (BE) is the premalignant manifestation of gastroesophageal reflux disease (GERD). Radiofrequency ablation (RFA) with and without endoscopic resection (ER) is a novel treatment for BE. Methods: Here we present a single-center update of the recommendations of a recent (June 2015) interdisciplinary expert panel meeting on the management of BE with dysplasia as well as cancer-positive and cancer-negative BE. We conducted a PubMed search of studies published in 2016 and 2017 on the topic of BE and RFA...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
https://www.readbyqxmd.com/read/29228128/evaluation-of-a-novel-infra-red-endoscopy-system-in-the-assessment-of-early-neoplasia-in-barretts-esophagus-pilot-study-from-a-single-center
#15
J Ortiz-Fernandez-Sordo, S Sami, R Mansilla-Vivar, V Subramanian, J Mannath, E Telakis, K Ragunath
Infrared endoscopy (IRE) has been shown to be useful in detecting submucosal (SM) invasion in early gastric cancer. Its role in the endoscopic assessment of Barrett's neoplasia has not been reported to date. We aimed in this study to evaluate the role of IRE in the detection and characterization of early neoplastic lesions within Barrett's esophagus (BE). The secondary aim was to explore its usefulness for the assessment of the presence of submucosal invasion in these early neoplastic Barrett's lesions. We included in the study patients with dysplastic BE who were referred to our institution for endoscopic therapy of a previously diagnosed early Barrett's neoplasia...
December 8, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29222735/delayed-perforation-after-endoscopic-submucosal-dissection-treated-successfully-by-temporary-stent-placement
#16
Masami Omae, Magnus Konradsson, Francisco Baldaque-Silva
A 71-year-old male patient with a long-segment (C10M12) Barrett's esophagus harboring multifocal high-grade dysplasia was referred to our clinic. After a multidisciplinary team conference and the patient's informed consent, an endoscopic submucosal dissection (ESD) was performed with resection of 4/5 of the esophageal circumference along 12 cm, without any complications during or immediately after the procedure. In the day after the ESD, the patient presented suddenly with dyspnea and subcutaneous emphysema in the neck and chest...
December 8, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29168641/economic-evaluation-of-endoscopic-radiofrequency-ablation-for-the-treatment-of-dysplastic-barrett-s-esophagus-in-spain
#17
José Miguel Esteban, Pedro González-Carro, Joan B Gornals, Carlos Collados, María Álvarez, Alejandro Pérez-Mitru, Suzan Serip
BACKGROUND AND STUDY AIMS: To assess the cost-effectiveness of introducing endoscopic treatment based on radiofrequency ablation plus endoscopic mucosal resection in selected patients into the standard of care of Barrett's esophagus patients with high-grade dysplasia or low-grade dysplasia in Spain. METHODS: The disease evolution was modeled via a semi-Markov model. The treatment strategies compared included endoscopic treatment based on radiofrequency ablation plus endoscopic mucosal resection and the Standard of Care (esophagectomy or palliative chemoradiotherapy according to disease status for high-grade dysplasia and endoscopic surveillance for low-grade dysplasia)...
March 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29129090/screening-and-prevention-strategies-and-endoscopic-management-of-early-esophageal-cancer
#18
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
#19
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
#20
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: Journal of Visualized Surgery
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