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Radiofrequency ablation of barrett's esophagus

Joke H Vliebergh, Pierre H Deprez, Danny de Looze, Marc Ferrante, Hans Orlent, Elisabeth Macken, Paul Christiaens, Fazia Mana, Gert De Hertogh, Hilde Willekens, Raf Bisschops
BACKGROUND:  Radiofrequency ablation (RFA), combined with endoscopic resection, can be used as a primary treatment for low grade dysplasia, high grade dysplasia, and early esophageal adenocarcinoma (EAC) in Barrett's esophagus (BE). The aim of the Belgian RFA registry is to capture the real-life outcome of endoscopic therapy for BE with RFA and to assess efficacy and safety outside study protocols, in the absence of reimbursement. PATIENTS AND METHODS:  Between February 2008 and January 2017, data from 7 different expert centers were prospectively collected in the registry...
October 25, 2018: Endoscopy
Herbert C Wolfsen
No abstract text is available yet for this article.
August 2018: Gastroenterology & Hepatology
Joana Castela, Miguel Serrano, Susana Mão de Ferro, Daniela Vinha Pereira, Paula Chaves, António Dias Pereira
Radiofrequency ablation therapy is an effective endoscopic option for the eradication of Barrett's esophagus that appears to reduce the risk of esophageal cancer. A concern associated with this technique is the development of subsquamous/buried intestinal metaplasia, whose clinical relevance and malignant potential have not yet been fully elucidated. Fewer than 20 cases of subsquamous neoplasia after the successful radiofrequency ablation of Barrett's esophagus have been reported to date. Here, we describe a new case of subsquamous neoplasia (high-grade dysplasia) following radiofrequency ablation that was managed with endoscopic resection...
October 5, 2018: Clinical Endoscopy
Tavankit Singh, Madhusudhan R Sanaka, Prashanthi N Thota
Since Barrett's esophagus is a precancerous condition, efforts have been made for its eradication by various ablative techniques. Initially, laser ablation was attempted in non-dysplastic Barrett's esophagus and subsequently, endoscopic ablation using photodynamic therapy was used in Barrett's patients with high-grade dysplasia who were poor surgical candidates. Since then, various ablative therapies have been developed with radiofrequency ablation having the best quality of evidence. Resection of dysplastic areas only without complete removal of entire Barrett's segment is associated with high risk of developing metachronous neoplasia...
September 16, 2018: World Journal of Gastrointestinal Endoscopy
Ravi Rajaram, Wayne L Hofstetter
Patients with esophageal intestinal metaplasia, or Barrett's esophagus, may undergo dysplastic changes that eventually lead to invasive adenocarcinoma. Endoscopic therapy in the form of radiofrequency ablation and cryoablation has been described as a minimally invasive intervention to halt this sequence of dysplasia to carcinoma. Studies demonstrate that the use of radiofrequency ablation and cryoablation is highly successful at eradicating intestinal metaplasia and dysplasia and reducing the risk of disease progression...
November 2018: Thoracic Surgery Clinics
(no author information available yet)
No abstract text is available yet for this article.
October 2018: Endoscopy
K Belghazi, R E Pouw, Cmt Sondermeijer, S L Meijer, E J Schoon, A D Koch, Blam Weusten, Jjghm Bergman
Background: The 360 Express balloon catheter (360 Express) has the ability to self-adjust to the esophageal lumen, ensuring optimal tissue contact. Objective: The objective of this article is to evaluate the efficacy and safety of the 360 Express for radiofrequency ablation (RFA) treatment of Barrett's esophagus (BE). Methods: BE patients with low-grade dysplasia (LGD), high-grade dysplasia (HGD) or early cancer (EC) were included. Visible lesions were removed by endoscopic resection (ER) prior to RFA...
August 2018: United European Gastroenterology Journal
Přemysl Falt, Ondřej Urban
Digestive endoscopy today is able to examine the whole gastrointestinal tract. On the basis of the originally purely diagnostic procedures a range of therapeutic modalities has been developed over years, which in some indications have taken the place of surgical procedures and methods of invasive radiology. Of greatest importance are the methods of endoscopic resection and ablation designed for the treatment of early neoplasms of the digestive tract not accompanied by a significant risk of lymphatic and systemic dissemination...
2018: Vnitr̆ní Lékar̆ství
Nicola Frei, Remus Frei, Gian-Marco Semadeni, Wolfram Jochum, Stephan Brand, Jan Borovicka
BACKGROUND/AIMS: Eradication of early Barrett's neoplasia by endoscopic resection and radiofrequency ablation is safe and effective. In T1b adenocarcinoma, standard of care remains controversial. We investigated the therapeutic outcome between high-grade dysplasia (HGD)/mucosal adenocarcinoma and submucosal adenocarcinoma in Barrett's patients. We hypothesised similar outcome in low-risk (LR) T1b compared to T1a/HGD. METHODS: Patients with endoscopically treated Barrett's esophagus were included in a Swiss tertiary center cohort study...
September 3, 2018: Digestion
Spyridon Michopoulos
Esophageal adenocarcinoma (EAC) arising on Barrett esophagus (BE) has become the most frequent type of esophageal malignancy in the Western world. BE is a frequent condition but progression to EAC is rare. Scientific societies publish guidelines in order to improve patients' care. However, there are fields where evidence is lacking or there are many controversies. We aimed to spotlight the most important changes, as well as the points of controversy in the recently published guidelines for BE. For most, a length ≥1 cm of a salmon-pink mucosa extending above the eso-gastric junction is required in order to define BE, accompanied with the presence of intestinal metaplasia (IM) at histology...
July 2018: Annals of Translational Medicine
Mohammad Farhad Peerally, Pradeep Bhandari, Krish Ragunath, Hugh Barr, Clive Stokes, Rehan Haidry, Laurence Lovat, Howard Smart, Rebecca Harrison, Karen Smith, Tom Morris, John S de Caestecker
BACKGROUND AND AIMS: Endoscopic resection (ER) is safe and effective for Barrett's esophagus (BE) containing high-grade dysplasia (HGD) or mucosal adenocarcinoma (T1A). The risk of metachronous neoplasia is reduced by ablation of residual BE by using radiofrequency ablation (RFA) or argon plasma coagulation (APC). These have not been compared directly. We aimed to recruit up to 100 patients with BE and HGD or T1A confirmed by ER over 1 year in 6 centers in a randomized pilot study. METHODS: Randomization was 1:1 to RFA or APC (4 treatments allowed at 2-month intervals)...
August 1, 2018: Gastrointestinal Endoscopy
Sarra Oumrani, Maximilien Barret, Frédéric Beuvon, Sarah Leblanc, Stanislas Chaussade, Frédéric Prat
Radiofrequency ablation is a recommended treatment option for residual Barrett's esophagus after endoscopic resection of a visible lesion. We herein report 3 cases of esophageal adenocarcinoma arising during the course of radiofrequency ablation, all of which were successfully resected by endoscopic submucosal dissection. Partial or suboptimal response to radiofrequency ablation or early recurrence of Barrett's mucosa after radiofrequency ablation should raise suspicion for adenocarcinoma and lead to consideration of en bloc resection by endoscopic submucosal dissection...
July 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Stefan Seewald, Tiing Leong Ang, Roos E Pouw, Fridolin Bannwart, Jacques J Bergman
Barrett's esophagus with high-grade dysplasia and early-stage adenocarcinoma is amenable to curative treatment by endoscopic resection. Histopathological correlation has established that mucosal cancer has minimal risk of nodal metastases and that long-term complete remission can be achieved. Although surgery is the gold-standard treatment once there is submucosal involvement, even T1sm1 (submucosal invasion ≤ 500 μm) cases without additional risk factors for nodal metastases might also be cured with endoscopic resection...
June 23, 2018: Digestive Diseases and Sciences
Sanne N van Munster, Anouk Overwater, Rehan Haidry, Raf Bisschops, Jacques J G H M Bergman, Bas L A M Weusten
BACKGROUND AND AIMS: Radiofrequency ablation (RFA) is safe and effective for eradicating Barrett's esophagus (BE) but is associated with significant postprocedural pain. Alternatively, balloon-based focal cryoablation (CRYO) has recently been developed, which preserves the extracellular matrix and might therefore be less painful. Although data for CRYO are still limited, uncontrolled studies suggest comparable safety and efficacy to RFA in eradicating limited BE areas. Therefore, secondary endpoints such as pain might become decisive for treatment selection...
November 2018: Gastrointestinal Endoscopy
Mimi C Tan, Kavin A Kanthasamy, Allison G Yeh, Daniel Kil, Lisa Pompeii, Xiaoying Yu, Hashem B El-Serag, Aaron P Thrift
BACKGROUND & AIMS: Radiofrequency ablation (RFA) is effective treatment for Barrett's esophagus (BE). However, some patients have recurrence after complete eradication of intestinal metaplasia (CEIM). We investigated the incidence of and factors associated with BE recurrence, with or without neoplasia, after RFA and CEIM using data from the national Veterans Affairs (VA) healthcare system. METHODS: We performed a retrospective cohort study of Veterans with BE treated by RFA from 2005 through 2016 with follow-up endoscopy...
June 11, 2018: Clinical Gastroenterology and Hepatology
Jana Krajciova, Zuzana Vackova, Julius Spicak, Jan Martinek
Barrett's esophagus (BE) is a premalignant condition associated with increased risk of developing esophageal adenocarcinoma. In the past, BE patients with high-grade intraepithelial neoplasia (IEN) or early adenocarcinoma (EAC) were indicated for esophagectomy. With the recent advance in endoscopy, endoscopic techniques have surpassed esophagectomy in the treatment of Barrett's esophagus-related neoplasia and minimized the treatment-related morbidity. Patients with IEN are candidates for endoscopic treatment - endoscopic mucosal resection (ER) of visible lesions and/or ablation therapy of flat Barrett's mucosa...
August 2018: Minerva Chirurgica
Tyler Luckett, Chaitanya Allamneni, Kevin Cowley, John Eick, Allison Gullick, Shajan Peter
BACKGROUND: We aim to investigate factors that may contribute to failure of eradication of dysplastic Barrett's Esophagus among patients undergoing radiofrequency ablation treatment. METHODS: A retrospective review of patients undergoing radiofrequency ablation for treatment of Barrett's Esophagus was performed. Data analyzed included patient demographics, medical history, length of Barrett's Esophagus, number of radiofrequency ablation sessions, and histopathology...
May 21, 2018: BMC Gastroenterology
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...
August 2018: Digestive Diseases and Sciences
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
Gargi Pandey, Mubashir Mulla, Wyn G Lewis, Antonio Foliaki, David S Y Chan
BACKGROUND:  Barrett's esophagus (BE) is a premalignant condition characterized by replacement of the esophageal lining with metastatic columnar epithelium, and its management when complicated by low grade dysplasia (LGD) is controversial. This systematic review and meta-analysis aimed to determine the efficacy of radiofrequency ablation (RFA) in patients with LGD. METHODS:  MEDLINE, EMBASE, and Web of Science were searched for studies including patients with BE-associated LGD receiving RFA (January 1990 to May 2017)...
October 2018: Endoscopy
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