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Radio frequency ablation Barrett

Craig S Brown, Michael B Ujiki
Esophageal adenocarcinoma has the fastest growing incidence rate of any cancer in the United States, and currently carries a very poor prognosis with 5 years relative survival rates of less than 15%. Current curative treatment options are limited to esophagectomy, a procedure that suffers from high complication rates and high mortality rates. Metaplasia of the esophageal epithelium, a condition known as Barrett's esophagus (BE), is widely accepted as the precursor lesion for adenocarcinoma of the esophagus...
May 16, 2015: World Journal of Gastrointestinal Endoscopy
Rehan Haidry, Laurence Lovat, Prateek Sharma
Barrett's oesophagus is the only know pre-cursor to oesophageal adenocarcinoma. The incidence of OAC is growing rapidly in the western world with a poor prognosis for most with a 5-year survival of only 15%. The approach to treating patients with neoplasia arising within BE has dramatically changed in the past 5 years. Resection of visible lesions with endoscopic mucosal resection followed by field ablation with radio-frequency ablation is now the accepted standard of care in these patients worldwide. This combined approach has shown high rates of disease reversal in several high quality clinical trials but also large volume registry studies...
March 2015: Current Gastroenterology Reports
Paulina Salminen, Jari Räsänen, Ari Ristimäki, Juha Saarnio, Markku Heikkinen, Simo Laine, Tarmo Koivisto, Martti Färkkilä
Barrett's esophagus occurs in a little less than 2% of the population. Of the patients, very few develop esophageal adenocarcinoma, and on the other hand only a small part of esophageal adenocarcinoma patients are diagnosed with Barrett's lesion. If Barrett's lesion has a separate visible elevated or depressed lesion it should first be treated with endoscopic mucosal resection, and thereafter the remaining Barrett's lesion should be destructed by a new technique called radiofrequency ablation, RFA. After destruction of the aberrant mucosal lesion with RFA it will be replaced with normal esophageal mucosa and the risk for malignant trasformation is dimished near to zero...
2014: Duodecim; Lääketieteellinen Aikakauskirja
Shanmugarajah Rajendra, Prateek Sharma
Barrett's esophagus (BE) is the most important and recognizable precursor lesion for esophageal adenocarcinoma (EAC), which is the one of the fastest-growing cancers in the Western world (600 % in the U.S. in the last 40 years), and therefore it is critical to manage the risk of cancer present in BE. New developments in imaging and molecular markers, as well as an armamentarium of novel and effective endoscopic eradication therapy - especially radio-frequency ablation (RFA) and endoscopic mucosal resection (EMR) - are now available to the interventional endoscopist to help curb the significant rise of esophageal adenocarcinoma (EAC)...
June 2014: Current Treatment Options in Gastroenterology
K K Wang, J M Tian, E Gorospe, J Penfield, G Prasad, T Goddard, M Wongkeesong, N S Buttar, L Lutzke, S Krishnadath
The management of high-grade dysplasia in Barrett's esophagus has clearly changed over recent years. The risk of cancer development is still substantial, with about one in three patients developing cancer, but a number of patients do not develop cancer. The nature of high-grade dysplasia has also been genetically elucidated with more evidence of chromosomal instability being present at this stage than previously thought. Therapy of the condition has evolved more toward endoscopic therapy, given the good results of radio-frequency ablation and photodynamic therapy in eliminating dysplasia and decreasing cancer development in randomized controlled trial...
May 2012: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
V L Owens, D A Katzka, L S Lutzke, K K Wang, T C Smyrk
Markedly increased esophageal eosinophils are associated with allergy- or reflux-based eosinophilic esophagitis. Other known disorders that cause this entity are unusual. To characterize the clinical, endoscopic, and histological findings of patients who develop marked esophageal eosinophilic infiltration after ablative therapy for Barrett's dysplasia. All patients who underwent endoscopic ablation of Barrett's esophagus between 1991 and 2009 with photodynamic therapy or radio frequency were screened for a pathologic descriptor of 'eosinophils' on biopsy...
January 2012: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
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