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Endoscopic resection in Barrett's esophagus

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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
#1
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
#2
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
#3
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
#4
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
#5
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 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)...
November 23, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29129090/screening-and-prevention-strategies-and-endoscopic-management-of-early-esophageal-cancer
#6
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
#7
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
#8
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
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
#9
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
#10
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...
February 2018: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28993137/endoscopic-submucosal-dissection-for-early-barrett-s-neoplasia-a-meta-analysis
#11
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
#12
(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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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