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Endoscopic resection in Barrett's esophagus

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https://www.readbyqxmd.com/read/28577773/esophagectomy-for-superficial-esophageal-neoplasia
#1
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
#2
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
#3
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
#4
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
#5
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.
May 11, 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
#6
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
#7
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
Am J Gastroenterol advance online publication, 1 June 2017; doi:10.1038/ajg.2017.166.
June 1, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28548120/early-barrett-esophagus-related-neoplasia-in-segments-1%C3%A2-cm-or-longer-is-always-associated-with-intestinal-metaplasia
#8
Benjamin Michael Allanson, Jessica Bonavita, Bob Mirzai, Tze Sheng Khor, Spiro C Raftopoulos, Willem Bastiaan de Boer, Ian S Brown, Marian Priyanthi Kumarasinghe
The assumption that intestinal metaplasia is a prerequisite for intraepithelial neoplasia/dysplasia and adenocarcinoma in the distal esophagus has been challenged by observations of adenocarcinoma without associated intestinal metaplasia. This study describes our experience of intestinal metaplasia in association with early Barrett neoplasia in distal esophagus and gastroesophageal junction. We reviewed the first endoscopic mucosal resection of 139 patients with biopsy-proven neoplasia. In index endoscopic mucosal resection, 110/139 (79%) cases showed intestinal metaplasia...
May 26, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28541099/cost-effectiveness-analysis-of-endoscopic-eradication-therapy-for-treatment-of-high-grade-dysplasia-in-barrett-s-esophagus
#9
Alex Filby, Matthew Taylor, Gideon Lipman, Laurence Lovat, Rehan Haidry
AIM: The aim was to evaluate the cost-effectiveness of endoscopic eradication therapy (EET) with combined endoscopic mucosal resection and radiofrequency ablation for the treatment of high-grade dysplasia (HGD) arising in patients with Barrett's esophagus compared with endoscopic surveillance alone in the UK. MATERIALS & METHODS: The cost-effectiveness model consisted of a decision tree and modified Markov model. A lifetime time horizon was adopted with the perspective of the UK healthcare system...
May 25, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/28540761/current-and-future-treatment-options-for-esophageal-cancer-in-the-elderly
#10
Elfriede Bollschweiler, Patrick Plum, Stefan P Mönig, Arnulf H Hölscher
Esophageal cancer is the eighth most common cancer globally and has the sixth worst prognosis because of its aggressiveness and poor survival. Data regarding cancer treatment in older patients is limited because the elderly have been under-represented in clinical trials. Therefore, we reviewed the existing literature regarding treatment results for elderly patients (70+ years). Areas covered: We used pubmed to analyze the actual literature according to elderly esophageal cancer patients with subheading of incidence, esophagectomy, chemoradiation or chemotherapy...
June 7, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28469359/probe-confocal-laser-endomicroscopy-in-the-therapeutic-endoscopic-management-of-barrett-s-dysplasia
#11
Fabrice Caillol, Sebastien Godat, Flora Poizat, Aurélie Auttret, Christian Pesenti, Erwan Bories, Jean Phillipe Ratone, Marc Giovannini
BACKGROUND: Endoscopic management of Barrett's esophagus (BE) depends on the histological stage of BE and includes the following: follow up, endotherapy with thermal ablation, and piecemeal or monobloc endoscopic resection (ER). We know that biopsies are unreliable in 20-75% of cases. The aim of our study was to evaluate the efficiency of probe confocal laser endomicroscopy (pCLE) in the diagnosis of the histological stage of BE, compared with the final histological results after ER. METHODS: This retrospective study was based on a prospective registry of patients referred for management of BE-associated dysplasia...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28455160/long-term-follow-up-results-of-stepwise-radical-endoscopic-resection-for-barrett-s-esophagus-with-early-neoplasia
#12
Kamar Belghazi, Frederike G I van Vilsteren, Bas L A M Weusten, Sybren L Meijer, Jacques J G H M Bergman, Roos E Pouw
BACKGROUND & AIMS: Stepwise radical endoscopic resection (SRER) has shown to be effective in eradicating Barrett's esophagus (BE) and its associated dysplasia. The aim of this study was to assess the long-term durability after successful SRER for early Barrett's neoplasia. METHODS: Patients who were treated with SRER for BE ≤5 cm with high-grade dysplasia (HGD) or early cancer (EC) and had reached complete eradication of intestinal metaplasia (CE-IM) and neoplasia (CE-neo) were included...
April 25, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28447001/overview-of-esophageal-cancer
#13
Ghulam Abbas, Mark Krasna
Esophageal cancer is a male-dominant aggressive malignancy and a leading cause of cancer-related mortality worldwide. Squamous cell carcinoma and adenocarcinoma are the two predominant histological subtypes with varying geographical and racial distribution. Globally, squamous cell carcinoma remains the most common histological type. In Western countries, however, adenocarcinoma has become the leading histological subtype, corresponding to a rise in the incidence of obesity, gastro-esophageal reflux disease and Barrett's esophagus...
March 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28446998/pathology-of-esophageal-cancer-and-barrett-s-esophagus
#14
REVIEW
Shilpa Jain, Sadhna Dhingra
Esophageal cancer is a serious malignancy with high mortality. The two common distinctive pathologic subtypes of esophageal cancer are squamous cell carcinoma and adenocarcinoma. These differ with regards to etiology, ethnic distribution, pathogenesis, and location in the esophagus. The precursor lesions are also unique to each subtype. Squamous cell carcinoma is more common in East Asia, is linked to smoking and tobacco use, more commonly involves the middle esophagus, and the precursor lesion is squamous dysplasia...
March 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28446997/endoscopic-submucosal-dissection-and-endoscopic-mucosal-resection-for-early-stage-esophageal-cancer
#15
REVIEW
Bo Ning, Mohamed M Abdelfatah, Mohamed O Othman
Mortality from esophageal cancer remains high despite advances in medical therapy. Although the incidence of squamous cell carcinoma of the esophagus remains unchanged, the incidence of the esophageal adenocarcinoma has increased over time. Gastroesophageal reflux disease (GERD and obesity are contributing factors to the development of Barrett's esophagus and subsequent development of adenocarcinoma. Early recognition of the disease can lead to resection of esophageal cancer prior to the development of lymphovascular invasion...
March 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28425653/endoscopic-gastric-mucosal-atrophy-distinguishes-the-characteristics-of-superficial-esophagogastric-junction-adenocarcinoma
#16
Noriya Uedo, Toshiyuki Yoshio, Shigetaka Yoshinaga, Manabu Takeuchi, Waku Hatta, Tomonori Yano, Tokuma Tanuma, Osamu Goto, Akiko Takahashi, Daniel Tong, Yeong Yeh Lee, Yoshiko Nakayama, Shin Ichihara, Takuji Gotoda
BACKGROUND AND AIM: Western studies have suggested two distinct etiologies of esophagogastric junction (EGJ) cancer: Helicobacter pylori-associated atrophic gastritis and non-atrophic gastric mucosa resembling esophageal adenocarcinoma. The present study investigated whether endoscopic gastric mucosal atrophy can distinguish between these two types of EGJ adenocarcinoma. METHODS: Data were collected from patients with Siewert type II, T1 EGJ adenocarcinoma who underwent endoscopic or surgical resection at eight Japanese institutions in 2010-2015...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28421454/quality-indicators-in-endoscopic-ablation-for-barrett-s-esophagus
#17
REVIEW
Samuel Han, Sachin Wani
Barrett's esophagus (BE) is a well-established premalignant condition for esophageal adenocarcinoma (EAC); a cancer that is associated with a poor 5-year survival rate. Several strategies have been explored in the context of reducing the burden of EAC. Endoscopic eradication therapy (EET) is considered the standard of care for the management of patients with BE with dysplasia and early neoplasia; a practice that has been endorsed by all gastroenterology societal guidelines. The effectiveness of EET has been demonstrated in multiple studies and contemporary management includes a combination of endoscopic mucosal resection (EMR) of all visible lesions followed by eradication of the remaining BE using ablative techniques of which radiofrequency ablation (RFA) has the best evidence supporting effectiveness and safety...
April 18, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28405317/changes-in-gene-expression-of-neo-squamous-mucosa-after-endoscopic-treatment-for-dysplastic-barrett-s-esophagus-and-intramucosal-adenocarcinoma
#18
Angelique Levert-Mignon, Michael J Bourke, Sarah J Lord, Andrew C Taylor, Antony R Wettstein, Melanie Edwards, Natalia K Botelho, Rebecca Sonson, Chatura Jayasekera, Oliver M Fisher, Melissa L Thomas, Finlay Macrae, Damian J Hussey, David I Watson, Reginald V Lord
BACKGROUND: Endoscopic therapy, including by radiofrequency ablation (RFA) or endoscopic mucosal resection (EMR), is first line treatment for Barrett's esophagus (BE) with high-grade dysplasia (HGD) or intramucosal cancer (IMC) and may be appropriate for some patients with low-grade dysplasia (LGD). OBJECTIVE: The purpose of this study was to investigate the molecular effects of endotherapy. METHODS: mRNA expression of 16 genes significantly associated with different BE stages was measured in paired pre-treatment BE tissues and post-treatment neo-squamous biopsies from 36 patients treated by RFA (19 patients, 3 IMC, 4 HGD, 12 LGD) or EMR (17 patients, 4 IMC, 13 HGD)...
February 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28353175/current-concepts-in-treatment-of-barrett-s-esophagus-with-and-without-dysplasia
#19
Francisco Schlottmann, Marco G Patti
BACKGROUND: Around 10-15% of patients with gastroesophageal reflux disease will develop Barrett's esophagus (BE). The development of novel endoscopic modalities has changed the management of BE in the last decade. AIM: The aim of this study was to review the current evidence for the treatment of BE with and without dysplasia. RESULTS: In patients with BE without dysplasia, antireflux surgery should not be suggested as a modality to prevent the malignant transformation of BE, but its indications should be the same as for other patients with gastroesophageal reflux...
March 28, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28342132/endoscopic-mucosal-resection-versus-esophagectomy-for-intramucosal-adenocarcinoma-in-the-setting-of-barrett-s-esophagus
#20
Chao Li, Denise Tami Yamashita, Jeffrey David Hawel, Drew Bethune, Harry Henteleff, James Ellsmere
BACKGROUND: Esophagectomy has been the standard of care for patients with intramucosal adenocarcinoma (IMC) in the setting of Barrett's esophagus. It is, however, associated with significant post-operative morbidity and mortality. Endoscopic mucosal resection (EMR) offers a minimally invasive approach with lesser morbidity. This study investigates the transition from esophagectomy to EMR for IMC with respect to eradication rates, post-operative morbidity, and long-term survival. METHODS: Patients diagnosed with IMC from 2005 to 2013 were identified retrospectively...
March 24, 2017: Surgical Endoscopy
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