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Radiofrequency ablation of barrett's esophagus

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https://www.readbyqxmd.com/read/28441152/cryoablation-in-the-management-of-barrett-s-esophagus
#1
Anouk Overwater, Bas L A M Weusten
PURPOSE OF REVIEW: Providing an overview on types of cryotherapy for esophageal application and their role in the management of Barrett's esophagus. RECENT FINDINGS: Recent studies have involved multiple types of cryotherapy including cryospray techniques that use either liquid nitrogen or carbon dioxide as the cryogenic fluid, and the CryoBalloon focal ablation device that uses nitrous oxide. Overall, studies report cryotherapy to be safe and effective in eradicating Barrett's epithelium...
April 24, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28421454/quality-indicators-in-endoscopic-ablation-for-barrett-s-esophagus
#2
REVIEW
Samuel Han, Sachin Wani
Barrett's esophagus (BE) is a well-established premalignant condition for esophageal adenocarcinoma (EAC); a cancer that is associated with a poor 5-year survival rate. Several strategies have been explored in the context of reducing the burden of EAC. Endoscopic eradication therapy (EET) is considered the standard of care for the management of patients with BE with dysplasia and early neoplasia; a practice that has been endorsed by all gastroenterology societal guidelines. The effectiveness of EET has been demonstrated in multiple studies and contemporary management includes a combination of endoscopic mucosal resection (EMR) of all visible lesions followed by eradication of the remaining BE using ablative techniques of which radiofrequency ablation (RFA) has the best evidence supporting effectiveness and safety...
April 18, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28405317/changes-in-gene-expression-of-neo-squamous-mucosa-after-endoscopic-treatment-for-dysplastic-barrett-s-esophagus-and-intramucosal-adenocarcinoma
#3
Angelique Levert-Mignon, Michael J Bourke, Sarah J Lord, Andrew C Taylor, Antony R Wettstein, Melanie Edwards, Natalia K Botelho, Rebecca Sonson, Chatura Jayasekera, Oliver M Fisher, Melissa L Thomas, Finlay Macrae, Damian J Hussey, David I Watson, Reginald V Lord
BACKGROUND: Endoscopic therapy, including by radiofrequency ablation (RFA) or endoscopic mucosal resection (EMR), is first line treatment for Barrett's esophagus (BE) with high-grade dysplasia (HGD) or intramucosal cancer (IMC) and may be appropriate for some patients with low-grade dysplasia (LGD). OBJECTIVE: The purpose of this study was to investigate the molecular effects of endotherapy. METHODS: mRNA expression of 16 genes significantly associated with different BE stages was measured in paired pre-treatment BE tissues and post-treatment neo-squamous biopsies from 36 patients treated by RFA (19 patients, 3 IMC, 4 HGD, 12 LGD) or EMR (17 patients, 4 IMC, 13 HGD)...
February 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28374819/disease-progression-in-barrett-s-low-grade-dysplasia-with-radiofrequency-ablation-compared-with-surveillance-systematic-review-and-meta-analysis
#4
REVIEW
Bashar J Qumseya, Sachin Wani, Sherif Gendy, Ben Harnke, Jacques J Bergman, Herbert Wolfsen
OBJECTIVES: Barrett's esophagus (BE) is the only identifiable premalignant condition for esophageal adenocarcinoma (EAC). Management of BE with low-grade dysplasia continues to be controversial. We aimed to conduct a systematic review and meta-analysis comparing the risk of progression to high-grade dysplasia or EAC among patients with BE with low-grade dysplasia treated with radiofrequency ablation (RFA) compared with surveillance endoscopy. METHODS: Our search included Medline, Embase, and Cochrane Central, was limited to English language articles, and was last searched on 31 December 2015...
April 4, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28353175/current-concepts-in-treatment-of-barrett-s-esophagus-with-and-without-dysplasia
#5
Francisco Schlottmann, Marco G Patti
BACKGROUND: Around 10-15% of patients with gastroesophageal reflux disease will develop Barrett's esophagus (BE). The development of novel endoscopic modalities has changed the management of BE in the last decade. AIM: The aim of this study was to review the current evidence for the treatment of BE with and without dysplasia. RESULTS: In patients with BE without dysplasia, antireflux surgery should not be suggested as a modality to prevent the malignant transformation of BE, but its indications should be the same as for other patients with gastroesophageal reflux...
March 28, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28303613/feasibility-of-liquid-nitrogen-cryotherapy-after-failed-radiofrequency-ablation-for-barrett-s-esophagus
#6
Arvind J Trindade, Sumant Inamdar, Shivangi Kothari, Joshua Berkowitz, Matthew McKinley, Vivek Kaul
OBJECTIVES: Radiofrequency ablation (RFA) for dysplastic Barrett's esophagus (BE) is highly effective. RFA failures are infrequent but can be a challenging cohort to manage. There is limited data on the feasibility of liquid nitrogen cryospray ablation for the complete eradication of dysplasia (CE-D) and/or intestinal metaplasia (CE-IM) after RFA has failed to achieve CE-IM in patients with dysplastic BE. METHODS: This is a retrospective review from two medical centers of prospectively maintained databases looking at patients that underwent liquid nitrogen cryospray ablation for refractory intestinal metaplasia post failed RFA...
March 16, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28205741/p-44-radiofrequency-ablation-in-treatment-of-barrett-s-esophagus-also-in-esophageal-atresia
#7
P De Angelis, P Trentino, E F Romeo, G Federici di Abriola, F Rea, T Caldaro, F Torroni, A C Contini, L Dall'Oglio, F Baldi
No abstract text is available yet for this article.
April 1, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28089850/radiofrequency-ablation-of-barrett-s-esophagus-reduces-esophageal-adenocarcinoma-incidence-and-mortality-in-a-comparative-modeling-analysis
#8
Sonja Kroep, Curtis R Heberle, Kit Curtius, Chung Yin Kong, Iris Lansdorp-Vogelaar, Ayman Ali, W Asher Wolf, Nicholas J Shaheen, Stuart J Spechler, Joel H Rubenstein, Norman S Nishioka, Stephen J Meltzer, William D Hazelton, Marjolein van Ballegooijen, Angela C Tramontano, G Scott Gazelle, E Georg Luebeck, John M Inadomi, Chin Hur
No abstract text is available yet for this article.
January 12, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28042239/oral-steroid-prophylaxis-is-effective-in-preventing-esophageal-strictures-after-large-endoscopic-resection
#9
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/28012849/patients-with-barrett-s-esophagus-and-confirmed-persistent-low-grade-dysplasia-are-at-increased-risk-for-progression-to%C3%A2-neoplasia
#10
Lucas C Duits, Myrtle J van der Wel, Cary C Cotton, K Nadine Phoa, Fiebo J W Ten Kate, Cees A Seldenrijk, G Johan A Offerhaus, Mike Visser, Sybren L Meijer, Rosalie C Mallant-Hent, Kausilia K Krishnadath, Roos E Pouw, Jan G P Tijssen, Nicholas J Shaheen, Jacques J G H M Bergman
BACKGROUND & AIMS: For patients with Barrett's esophagus, the diagnosis of low-grade dysplasia (LGD) is subjective, and reported outcomes vary. We analyzed data from a multicenter study of endoscopic therapy to identify factors associated with progression to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) in patients with LGD of the esophagus. METHODS: We performed a retrospective analysis of data from 255 patients with a primary diagnosis of LGD (78% men; mean age, 63 years) who participated in a randomized controlled trial of surveillance vs radiofrequency ablation in Europe...
April 2017: Gastroenterology
https://www.readbyqxmd.com/read/27999692/polypoid-dysplasia-in-barrett-s-esophagus-diagnosis-management-and-very-different-outcomes-in-two-consecutive-cases
#11
Megan Murphy, Christina Tofani, Kunjal Gandhi, Anthony Infantolino
Background. Barrett's esophagus is associated with an increased risk of adenocarcinoma. Dysplasia in Barrett's esophagus is a precursor to adenocarcinoma. Rarely, dysplastic polypoid lesions are superimposed on Barrett's esophagus. Most reported cases of polypoid dysplasia in Barrett's esophagus have been advanced on presentation and treated with esophagectomy. We describe two cases of polypoid changes in Barrett's esophagus and treatment with polypectomy followed by radiofrequency ablation. Cases. A 75 yo male presented with esophageal polyps, which on biopsy showed gastric cardia/foveolar mucosa with focal intestinal metaplasia without dysplasia...
2016: Case Reports in Gastrointestinal Medicine
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
#12
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/27971324/cost-effectiveness-of-endoscopic-treatment-with-radiofrequency-ablation-for-patients-with-barrett-s-esophagus-and-high-or-low-grade-dysplasia-in-spain
#13
J M Esteban, P González Carro, J Gornals, C Collados, M Álvarez, A Pérez-Mitru, S Serip
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27956164/the-cost-effectiveness-of-radiofrequency-ablation-for-barrett-s-esophagus-with-low-grade-dysplasia-results-from-a-randomized-controlled-trial-surf-trial
#14
K Nadine Phoa, Wilda D Rosmolen, Bas L A M Weusten, Raf Bisschops, Erik J Schoon, Shefali Das, Krish Ragunath, G Fullarton, Massimiliano DiPietro, Narayanasamy Ravi, Jan G P Tijssen, Marcel G W Dijkgraaf, Jacques J G H M Bergman
BACKGROUND AND AIMS: The Surveillance versus Radiofrequency Ablation (SURF) trial randomized 136 patients with Barrett's esophagus (BE) containing low-grade dysplasia (LGD), to receive radiofrequency ablation (ablation, n = 68) or endoscopic surveillance (control, n = 68). Ablation reduced the risk of neoplastic progression to high-grade dysplasia and esophageal adenocarcinoma (EAC) by 25% over 3 years (1.5% for ablation vs 26.5% for control). We performed a cost-effectiveness analysis from a provider perspective alongside this trial...
December 9, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27855466/detection-of-lesions-in-dysplastic-barrett-s-esophagus-by-community-and-expert-endoscopists
#15
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...
February 2017: Endoscopy
https://www.readbyqxmd.com/read/27812392/periesophageal-pseudoaneurysms-rare-cause-of-refractory-bleeding-treated-with-transarterial-embolization
#16
Divyanshoo R Kohli, Rachit D Shah, Daniel J Komorowski, George B Smallfield
A 43-year-old female with history of systemic lupus erythematosus, prior cytomegalovirus esophagitis treated with ganciclovir, and long segment Barrett's esophagus (Prague class C8 M9) with high grade dysplasia treated with radiofrequency ablation presented to the hospital with hematemesis. An upper gastrointestinal endoscopy showed multiple esophageal ulcers with active arterial spurting which could not be controlled with endoscopic interventions including placement of hemostatic clips. An emergent angiogram demonstrated actively bleeding saccular dilations (pseudoaneurysms) in the esophageal branches of the lower thoracic aorta as well as left gastric artery for which gelfoam and coil embolization was initially successful...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27725648/clinical-outcomes-following-recurrence-of-intestinal-metaplasia-after-successful-treatment-of-barrett-s-esophagus-with-radiofrequency-ablation
#17
Athidi Guthikonda, Cary C Cotton, Ryan D Madanick, Melissa B Spacek, Susan E Moist, Kathleen Ferrell, Evan S Dellon, Nicholas J Shaheen
OBJECTIVES: Radiofrequency ablation (RFA) is an effective treatment for Barrett's esophagus (BE). However, recurrence of BE after initially successful RFA is common, and outcomes following recurrence not well described. We report the outcomes associated with recurrence following initially successful RFA. METHODS: We performed a retrospective cohort study of 306 patients treated with RFA for dysplastic BE. Complete eradication of intestinal metaplasia (CE-IM) was defined as complete histological and endoscopic remission of IM...
January 2017: American Journal of Gastroenterology
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
#18
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
#19
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/27588293/reimbursement-in-endoscopy-how-can-new-procedures-be-implemented
#20
REVIEW
Michael-Holger Wilke, Markus Rathmayer
BACKGROUND: New procedures in endoscopy take time to be incorporated in the German diagnosis-related groups (DRG) system. Depending on the extent of innovation and the costs, several pathways are possible. METHODS: This article provides an overview of possible pathways to implement new procedures in the German DRG payment system. Additionally, we compare the results of 2 surveys on the system of New Diagnostic and Treatment Methods (Neue Untersuchungs- und Behandlungsmethoden; NUB)...
February 2016: Visceral Medicine
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