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Radiofrequency ablation of barrett's esophagus

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https://www.readbyqxmd.com/read/30228886/a-single-step-sizing-and-radiofrequency-ablation-catheter-for-circumferential-ablation-of-barrett-s-esophagus-results-of-a-pilot-study
#1
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
https://www.readbyqxmd.com/read/30223668/therapeutic-digestive-endoscopy-i
#2
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
https://www.readbyqxmd.com/read/30176662/endoscopic-treatment-of-early-barrett-s-adenocarcinoma-and-dysplasia-focus-on-submucosal-cancer
#3
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
https://www.readbyqxmd.com/read/30094245/critical-appraisal-of-guidelines-for-screening-and-surveillance-of-barrett-s-esophagus
#4
REVIEW
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
https://www.readbyqxmd.com/read/30076843/radiofrequency-ablation-compared-with-argon-plasma-coagulation-after-endoscopic-resection-of-high-grade-dysplasia-or-t1-adenocarcinoma-in-barrett-s-esophagus-a-randomized-pilot-study-bride
#5
Mohammad Farhad Peerally, Pradeep Bhandari, Krish Ragunath, Hugh Barr, Rehan Haidry, Laurence Lovat, Howard Smart, Rebecca Harrison, Clive Stokes, 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); risk of metachronous neoplasia is reduced by ablation of residual BE using radiofrequency ablation (RFA) or argon plasma coagulation (APC). These have not been directly compared. We aimed to recruit up to 100 patients with BE and HGD or T1A confirmed by ER over 1 year in 6 centres in a randomized pilot study. METHODS: Randomization was 1:1 to RFA or APC (4 treatments allowed at 2 month intervals); recruitment, retention, dysplasia clearance, clearance of benign BE, adverse events, healthcare costs, and quality of life (QoL) using EQ-5D, EORTC QLQ-C30, OES18 were assessed up to the end of the trial at 12 months...
August 1, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29991901/salvage-endoscopic-submucosal-dissection-for-esophageal-adenocarcinoma-arising-during-radiofrequency-ablation
#6
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
https://www.readbyqxmd.com/read/29934725/management-of-early-stage-adenocarcinoma-of-the-esophagus-endoscopic-mucosal-resection-and-endoscopic-submucosal-dissection
#7
REVIEW
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
https://www.readbyqxmd.com/read/29928869/focal-cryoballoon-versus-radiofrequency-ablation-of-dysplastic-barrett-s-esophagus-impact-on-treatment-response-and-postprocedural-pain
#8
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...
June 19, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29902646/factors-associated-with-recurrence-of-barrett-s-esophagus-after-radiofrequency-ablation
#9
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
https://www.readbyqxmd.com/read/29806757/radiofrequency-ablation-for-barrett-s-esophagus-related-neoplasia
#10
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
https://www.readbyqxmd.com/read/29783927/length-of-barrett-s-segment-predicts-failure-of-eradication-in-radiofrequency-ablation-for-barrett-s-esophagus-a-retrospective-cohort-study
#11
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
https://www.readbyqxmd.com/read/29777441/mucosal-ablation-in-patients-with-barrett-s-esophagus-fry-or-freeze
#12
REVIEW
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
https://www.readbyqxmd.com/read/29720850/diagnosis-and-treatment-of-superficial-esophageal-cancer
#13
REVIEW
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
https://www.readbyqxmd.com/read/29689573/systematic-review-and-meta-analysis-of-the-effectiveness-of-radiofrequency-ablation-in-low-grade-dysplastic-barrett-s-esophagus
#14
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)...
April 24, 2018: Endoscopy
https://www.readbyqxmd.com/read/29671157/natural-history-of-the-post-ablation-esophagus
#15
REVIEW
Craig C Reed, Nicholas J Shaheen
Endoscopic ablative therapy including radiofrequency ablation (RFA) represents the preferred management strategy for dysplastic Barrett's esophagus (BE) and appears to diminish the risk of developing esophageal adenocarcinoma (EAC). Limited data describe the natural history of the post-ablation esophagus. Recent findings demonstrate that recurrent intestinal metaplasia (IM) following RFA is relatively frequent. However, dysplastic BE and EAC subsequent to the complete eradication of intestinal metaplasia (CEIM) are uncommon...
August 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29655833/development-of-evidence-based-surveillance-intervals-after-radiofrequency-ablation-of-barrett-s-esophagus
#16
Cary C Cotton, Rehan Haidry, Aaron P Thrift, Laurence Lovat, Nicholas J Shaheen
BACKGROUND & AIMS: Barrett's esophagus (BE) recurs in 25% or more of patients treated successfully with radiofrequency ablation (RFA), so surveillance endoscopy is recommended after complete eradication of intestinal metaplasia (CEIM). The frequency of surveillance is informed only by expert opinion. We aimed to model the incidence of neoplastic recurrence, validate the model in an independent cohort, and propose evidence-based surveillance intervals. METHODS: We collected data from the United States Radiofrequency Ablation Registry (US RFA, 2004-2013) and the United Kingdom National Halo Registry (UK NHR, 2007-2015) to build and validate models to predict the incidence of neoplasia recurrence after initially successful RFA...
August 2018: Gastroenterology
https://www.readbyqxmd.com/read/29524114/cryotherapy-and-radiofrequency-ablation-for-eradication-of-barrett-s-esophagus-with-dysplasia-or-intramucosal-cancer
#17
Prashanthi N Thota, Zubin Arora, John A Dumot, Gary Falk, Tanmayee Benjamin, John Goldblum, Sunguk Jang, Rocio Lopez, John J Vargo
BACKGROUND AND AIMS: Endoscopic ablation therapy has become the mainstay of treatment of Barrett's associated dysplasia and intramucosal cancer (IMC). The widely available techniques for ablation are radiofrequency ablation (RFA) and cryotherapy. Our aim was to compare eradication rates of metaplasia and dysplasia with both these modalities. PATIENTS AND METHODS: Retrospective review of prospectively collected database of patients who underwent endoscopic therapy for Barrett's dysplasia or IMC from 2006 to 2011 was performed...
May 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29476849/cryotherapy-for-persistent-barrett-s-esophagus-after-radiofrequency-ablation-a-systematic-review-and-meta-analysis
#18
REVIEW
Kavel Visrodia, Liam Zakko, Siddharth Singh, Cadman L Leggett, Prasad G Iyer, Kenneth K Wang
BACKGROUND AND AIMS: A small but significant proportion of patients with Barrett's esophagus (BE) have persistent dysplasia or intestinal metaplasia (IM) after treatment with radiofrequency ablation (RFA). Cryotherapy is a cold-based ablative modality that is increasingly being used in this setting. We aimed to better understand the efficacy of second-line cryotherapy in patients with BE who have persistent dysplasia or IM after RFA by conducting a systematic review and meta-analysis...
June 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29351156/liquid-nitrogen-spray-cryotherapy-is-associated-with-less-postprocedural-pain-than-radiofrequency-ablation-in-barrett-s-esophagus-a-multicenter-prospective-study
#19
Sanjeev S Solomon, Shivangi Kothari, George B Smallfield, Sumant Inamdar, Peter Stein, Viviana A Rodriguez, Adam P Sima, Krystle Bittner, Alvin M Zfass, Vivek Kaul, Arvind J Trindade
GOALS AND BACKGROUND: Two common endoscopic therapies for eradication of dysplastic Barrett's esophagus are radiofrequency ablation (RFA) and liquid nitrogen spray cryotherapy (LNC). There is no data comparing postprocedural pain. This study aimed to compare the incidence of postprocedural pain between the 2 ablation modalities. METHODS: This is a multicenter prospective study in which pain intensity scores and the presence of dysphagia were assessed immediately before and after treatment, 48 hours posttreatment and at 3 weeks posttreatment using validated instruments...
January 18, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29250106/update-on-the-management-of-barrett-s-esophagus-in-austria
#20
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
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