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Endoscopic resection in Barrett's esophagus

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https://www.readbyqxmd.com/read/28078459/endotherapy-in-case-of-relapse-of-neoplastic-barrett-s-esophagus-after-successful-initial-endoscopic-resection
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
November 17, 2016: 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
#8
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
#9
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
#10
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...
September 23, 2016: 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
#11
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
#12
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
#13
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...
August 31, 2016: Annual Review of Medicine
https://www.readbyqxmd.com/read/27573771/what-makes-an-expert-barrett-s-histopathologist
#14
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
#15
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
#16
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
https://www.readbyqxmd.com/read/27541732/endoscopic-treatment-of-high-grade-dysplasia-and-intramucosal-esophageal-adenocarcinoma
#17
Craig C Reed, Nicholas J Shaheen
The endoscopic management of Barrett's esophagus (BE) has changed with the emergence of novel endoscopic technologies and new data informing the care of dysplastic BE and early adenocarcinoma. These changes include an expanded use of endoscopic ablative therapy as well new recommendations for surveillance intervals. For most patients with BE and high-grade dysplasia (HGD), endoscopic ablative therapy is the preferred treatment strategy. Ablation has consistently been shown to be effective, with less morbidity compared with surgery...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27541368/esophagectomy-as-a-treatment-consideration-for-early-stage-esophageal-cancer-and-high-grade-dysplasia
#18
Patrick J McLaren, James P Dolan
In recent years, a number of endoluminal procedures such as endoscopic resection and thermal ablation have emerged as less invasive treatment options for early esophageal cancer. These therapies have demonstrated excellent oncologic outcomes for dysplasia as well as intramucosal cancers. However, few studies have directly compared long-term outcomes of endoscopic therapy versus traditional esophagectomy. Current esophagectomy techniques now deliver consistently good outcomes in the hands of experienced surgeons at high volume centers, and this option should be considered an important treatment consideration for early esophageal cancer...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27540572/recurrent-intestinal-metaplasia-at-the-gastroesophageal-junction-following-endoscopic-eradication-of-dysplastic-barrett-s-esophagus-may-not-be-benign
#19
Georgina R Cameron, Paul V Desmond, Chatura S Jayasekera, Francesco Amico, Richard Williams, Finlay A Macrae, Andrew C F Taylor
BACKGROUND AND STUDY AIMS: Radiofrequency ablation (RFA) combined with endoscopic mucosal resection (EMR) is effective for eradicating dysplastic Barrett's esophagus. The durability of response is reported to be variable. We aimed to determine the effectiveness and durability of RFA with or without EMR for patients with dysplastic Barrett's esophagus. PATIENTS AND METHODS: Patients with dysplastic Barrett's esophagus referred to two academic hospitals were assessed with high definition white-light endoscopy, narrow-band imaging, and Seattle protocol biopsies...
August 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27444824/correlation-between-endoscopic-forceps-biopsies-and-endoscopic-mucosal-resection-with-endoscopic-ultrasound-in-patients-with-barrett-s-esophagus-with-high-grade-dysplasia-and-early-cancer
#20
Prashanthi N Thota, Alaa Sada, Madhusudhan R Sanaka, Sunguk Jang, Rocio Lopez, John R Goldblum, Xiuli Liu, John A Dumot, John Vargo, Gregory Zuccarro
BACKGROUND: Patients with Barrett's esophagus (BE) and high-grade dysplasia (HGD) or intramucosal cancer (IMC) on endoscopic forceps biopsies are referred to endoscopic therapy even though forceps biopsies do not reflect the disease extent accurately. Endoscopic mucosal resection (EMR) and endoscopic ultrasound (EUS) are frequently used for staging prior to endoscopic therapy. Our aims were to evaluate: (1) if endoscopic forceps biopsies correlated with EMR histology in these patients; (2) the utility of EUS compared to EMR; and (3) if accuracy of EUS varied based on grade of differentiation of tumor...
July 21, 2016: Surgical Endoscopy
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