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Endoscopic mucosal resection in barrett's esophagus

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https://www.readbyqxmd.com/read/28301879/laparoscopic-transgastric-circumferential-stapler-assisted-vs-endoscopic-esophageal-mucosectomy-in-a-porcine-model
#1
Daniel C Steinemann, Andreas Zerz, Philip C Müller, Peter Sauer, Anja Schaible, Felix Lasitschka, Anne-Catherine Schwarz, Beat P Müller-Stich, Georg R Linke
Background and study aims Extensive endoscopic mucosal resection (EMR) for Barrett's esophagus (BE) may lead to stenosis. Laparoscopic, transgastric, stapler-assisted mucosectomy (SAM) with the retrieval of a circumferential specimen is proposed. Methods SAM was evaluated in two phases. The feasibility of SAM and the quality of specimens were assessed in eight animals. The mucosal healing was evaluated in a 6-week survival experiment comparing SAM (n = 6) with EMR (n = 6). The ratio of the esophageal lumen width (REL) at the resection level measured on fluoroscopy at 6 weeks divided by the width immediately after resection was compared...
March 16, 2017: Endoscopy
https://www.readbyqxmd.com/read/28275832/endoscopic-treatment-of-high-grade-dysplasia-and-early-esophageal-cancer
#2
Francisco Schlottmann, Marco G Patti, Nicholas J Shaheen
BACKGROUND: The emergence of novel endoscopic modalities has challenged the role of surgery for patients with Barrett's esophagus (BE) and high-grade dysplasia (HGD) or early esophageal adenocarcinoma. AIM: The aim of this study was to review the available evidence of the endoscopic treatment of HGD and early esopahgeal adenocarcinoma. RESULTS: For most patients with BE and HGD, endoscopic ablative therapy is the preferred treatment strategy...
March 8, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28187035/hepatocyte-antigen-expression-in-barrett-esophagus-and-associated-neoplasia
#3
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
#4
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/28042239/oral-steroid-prophylaxis-is-effective-in-preventing-esophageal-strictures-after-large-endoscopic-resection
#5
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
#6
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/27901624/endoscopic-mucosal-resection-for-barrett-s-esophagus
#7
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
#8
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/27783167/clinicopathological-features-of-siewert-type-ii-adenocarcinoma-comparison-of-gastric-cardia-adenocarcinoma-and-barrett-s-esophageal-adenocarcinoma-following-endoscopic-submucosal-dissection
#9
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/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...
March 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27621766/endoscopic-applications-of-cryospray-ablation-therapy-from-barrett-s-esophagus-and-beyond
#11
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/27556083/prospective-evaluation-of-the-clinical-utility-of-endoscopic-submucosal-dissection-esd-in-patients-with-barrett-s-esophagus-a-western-center-experience
#12
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/27540572/recurrent-intestinal-metaplasia-at-the-gastroesophageal-junction-following-endoscopic-eradication-of-dysplastic-barrett-s-esophagus-may-not-be-benign
#13
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
#14
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
https://www.readbyqxmd.com/read/27391867/current-treatment-options-for-esophageal-diseases
#15
Jan Martínek, Jun-Ichi Akiyama, Zuzana Vacková, Manuele Furnari, Edoardo Savarino, Teus J Weijs, Elen Valitova, Sylvia van der Horst, Jelle P Ruurda, Lucas Goense, George Triadafilopoulos
Exciting new developments-pharmacologic, endoscopic, and surgical-have arisen for the treatment of many esophageal diseases. Refractory gastroesophageal reflux disease presents a therapeutic challenge, and several new options have been proposed to overcome an insufficient effectiveness of proton pump inhibitors. In patients with distal esophageal spasm, drugs and endoscopic treatments are the current mainstays of the therapeutic approach. Treatment with proton pump inhibitors (or antireflux surgery) should be considered in patients with Barrett's esophagus, since a recent meta-analysis demonstrated a 71% reduction in risk of neoplastic progression...
October 2016: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/27362719/-upper-and-lower-gastrointestinal-endoscopy
#16
Emilio Di Giulio, Stefano Angeletti, Federico Desideri
Recent-years technological innovation has achieved two important objectives: 1) to develop advanced diagnostic tools able to determine with a fair degree of accuracy the nature of a lesion by means of the simple endoscopic observation; 2) to improve the therapeutic approach to lesions, by extending the least-invasive endoscopic treatment also to lesions that in the past were referred to surgery. Advanced diagnostic methodologies have been achieved thanks to the introduction of high definition endoscopes and virtual chromo-endoscopy...
June 2016: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/27347544/diagnostic-accuracy-of-mucosal-biopsy-versus-endoscopic-mucosal-resection-in-barrett-s-esophagus-and-related-superficial-lesions
#17
Hany M Elsadek, Mamdouh M Radwan
Background. Endoscopic surveillance for early detection of dysplastic or neoplastic changes in patients with Barrett's esophagus (BE) depends usually on biopsy. The diagnostic and therapeutic role of endoscopic mucosal resection (EMR) in BE is rapidly growing. Objective. The aim of this study was to check the accuracy of biopsy for precise histopathologic diagnosis of dysplasia and neoplasia, compared to EMR in patients having BE and related superficial esophageal lesions. Methods. A total of 48 patients with previously diagnosed BE (36 men, 12 women, mean age 49...
2015: International Scholarly Research Notices
https://www.readbyqxmd.com/read/27307161/-endoscopic-therapy-of-esophageal-diseases
#18
A May
The esophagus is one of the areas of the gastrointestinal tract, for which therapeutic concepts have changed the most over the last two decades. The most decisive advance is the development of endoscopic resection techniques for early esophageal carcinomas. These methods provide excellent short- and long-term results combined with very low morbidity and negligible mortality rates in comparison with surgical esophagectomy, especially in case of mucosal Barrett's adenocarcinoma. In addition, the endoscopic myotomy techniques in Zenker's diverticulum and spastic achalasia are new, attractive endoscopic treatment modalities...
August 2016: Der Internist
https://www.readbyqxmd.com/read/27171331/-endoscopic-mucosal-resection-emr-followed-by-radiofrequency-ablation-rfa-in-neoplastic-barrett-s-esophagus-or-barrett-early-cancer-is-also-economically-superior-to-sole-radical-endoscopic-resection
#19
M Wilke, M Rathmayer, M Schenker, W Schepp
INTRODUCTION: Neoplastic changes (mild or high grade intraepithelial neoplasia (L- or HGIEN) or early cancer) in Barrett esophagus are treated with various methods. This study compares clinical-economical aspects of sole stepwise radical endoscopic resection (SRER) against combination treatment with EMR (Endoscopic mucosal resection) and RFA (radiofrequency ablation). MATERIAL AND METHODS: Based on clinical data from a randomized controlled trial 1 we developed an economic model for costs of treatment according to the German Hospital Remuneration System (G-DRG)...
May 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27092332/the-endorotor-%C3%A2-endoscopic-mucosal-resection-system-for-non-thermal-and-rapid-removal-of-esophageal-gastric-and-colonic-lesions-initial-experience-in-live-animals
#20
Stephan Hollerbach, Axel Wellmann, Peter Meier, Jeffery Ryan, Ramon Franco, Peter Koehler
BACKGROUND AND STUDY AIMS: The EndoRotor(®) is a novel, non-thermal, automated mechanical endoscopic resection system designed to remove benign mucosal neoplastic tissue throughout the gastrointestinal tract. It uses suction pressure to pull in mucosa and rapidly and precisely cut it while automatically transporting the samples to a collection trap for later histologic evaluation. PATIENTS AND METHODS: To study the technical properties and therapeutic potential of this new tool, we performed multiple upper and lower gastrointestinal endoscopic mucosal resections in three healthy live pigs...
April 2016: Endoscopy International Open
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