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rfa endoscopy

S Subramaniam, K Kandiah, F Chedgy, P Meredith, G Longcroft-Wheaton, P Bhandari
The current standard of treating early Barrett's neoplasia is resection of visible lesions using endoscopic mucosal resection (EMR) followed by ablative therapy to the Barrett's segment. There is increasing evidence to support the use of endoscopic submucosal dissection (ESD) where en-bloc resection and lower recurrence rates may be achieved. However, ESD is associated with deep submucosal dissection when compared to EMR. This may increase the risk of complications including stricture formation with subsequent radiofrequency ablation (RFA) therapy...
December 2, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
(no author information available yet)
Patients with Barrett's esophagus (BE)/columnar lined esophagus (CLE) and adenocarcinoma are increasing, in whom 0.61% BE/CLE would develop to adenocarcinoma. The prognosis of esophageal cancer is related to the tumor stage at diagnosis. To standardize the screening, diagnosis and therapy of BE and adenocarcinoma in China, 31 digestive diseases and digestive endoscopy experts and digestive histologists drafted the consensus on the basis of clinical experience and references. The consensus defined BE as a complication of gastroesophageal reflux disease...
September 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
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...
June 2017: American Journal of Gastroenterology
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
Muhammad Yasir Khan, Waqas Javed Siddiqui, Praneet S Iyer, Ahmed Dirweesh, Nigahus Karabulut
BACKGROUND Left atrial to esophageal fistula (LAEF) is a rare fatal complication of radiofrequency ablation (RFA) for atrial fibrillation and is associated with high mortality. Clinical features can be nonspecific and include fever, dysphagia, upper gastrointestinal (GI) bleeding, sepsis, and embolic stroke a after recent history of RFA for atrial fibrillation. CASE REPORT  A 57-year-old Caucasian male was brought to the emergency department (ED) by his family because of an altered mental status. He had undergone a radiofrequency ablation for paroxysmal atrial fibrillation three weeks earlier...
November 2, 2016: American Journal of Case Reports
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
Kuan-Chieh Fang, Chien-Wei Su, Yi-You Chiou, Pei-Chang Lee, Nai-Chi Chiu, Chien-An Liu, Ping-Hsien Chen, Wei-Yu Kao, Yi-Hsiang Huang, Teh-Ia Huo, Ming-Chih Hou, Han-Chieh Lin, Jaw-Ching Wu
OBJECTIVES: To assess the impact of clinically significant portal hypertension (CSPH) on the prognosis of patients with hepatocellular carcinoma (HCC) undergoing radiofrequency ablation (RFA). METHODS: We retrospectively enrolled 280 treatment-naïve early-stage HCC patients who had Child-Pugh grade A or B and received upper gastrointestinal endoscopy at the time of HCC diagnosis. CSPH was defined as (1) a platelet count < 100,000/mm(3) associated with splenomegaly and/or (2) the presence of oesophageal/gastric varices by endoscopy...
June 2017: European Radiology
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
P D James, L Antonova, M Martel, A Barkun
INTRODUCTION: The diversity, technical skills required, and risk inherent to advanced endoscopy techniques all contribute to complex training curricula and steep learning curves. Since trainees develop endoscopy skills at different rates, there has been a shift towards competency-based training and certification. Validated endoscopy performance measures for trainees are, therefore, necessary. The aim of this systematic review was to describe and critically assess the existing evidence regarding measures of performance for trainees in advanced endoscopy...
June 2016: Best Practice & Research. Clinical Gastroenterology
Walid El Sherbiny, Ashraf AbdelRahman, Muhammad Diasty, Shaker Wagih Shaltout
Hepatocellular carcinoma (HCC) has many options for management; some of them are complicated by development of portal hypertension (PHT). Doppler ultrasound is an effective method to diagnose and monitor PHT changes after HCC ablation procedures. The aim of this study is to investigate changes in portal pressure hemodynamics of HCC patients following treatment with different interventional strategies: radiofrequency ablation (RFA), microwave ablation (MWA), and transarterial chemoembolization (TACE). A total of 60 patients with HCC were divided into three main groups, and each group received a different type of therapy (RFA, MWA, and TACE)...
August 2016: Abdominal Radiology
Lisa Cassani, James C Slaughter, Patrick Yachimski
OBJECTIVES: Multiple endoscopic sessions may be necessary for treatment and surveillance of Barrett's esophagus (BE)-associated neoplasia. Adherence to an endoscopic therapeutic regimen is important for longitudinal management of BE. The objective of this study was to identify the factors associated with adherence to therapy for BE-associated neoplasia. METHODS: We retrospectively identified patients with BE whom were referred to a tertiary center for endoscopic mucosal resection (EMR) or radiofrequency ablation (RFA) between 2009 and 2012...
February 2016: United European Gastroenterology Journal
Keyur Parikh, Leena Khaitan
Barrett's esophagus (BE) is a premalignant condition that is associated with the development of esophageal adenocarcinoma. Risk factors that have been associated with the development of BE include male gender, Caucasian race, chronic gastroesophageal reflux disease, smoking, age >50 and obesity. The current management of BE is dependent on underlying pathological changes and treatment can range from surveillance endoscopy with daily proton pump inhibitor (PPI) therapy in the setting of intestinal metaplasia or low-grade dysplasia (LGD) to radiofrequency ablation (RFA), endoscopic mucosal resection or surgical resection in the setting of high-grade dysplasia...
2016: Journal of Surgical Case Reports
Wai K Leung, Daniel K H Tong, Suet Yi Leung, Fion S Y Chan, Teresa S M Tong, Ronnie S L Ho, Kent Man Chu, Simon Y K Law
BACKGROUND/AIMS: Patients with gastric intestinal metaplasia and dysplasia are at increased risk of gastric cancer development. We tested the feasibility of using endoscopic radiofrequency ablation for the treatment of dysplasia and metaplasia in the stomach. METHODOLOGY: Patients who had histologically confirmed low-grade gastric dysplasia or IM were recruited. Endoscopic RFA was performed at 8 week-intervals for a maximum of 3 sessions. All patients were followed up by endoscopy until 12 months post-RFA...
May 2015: Hepato-gastroenterology
J Ortiz-Fernández-Sordo, S Sami, R Mansilla-Vivar, J De Caestecker, A Cole, K Ragunath
OBJECTIVE: Evaluate the incidence of metachronous visible lesions (VLs) in patients referred for radiofrequency ablation (RFA) for early Barrett's neoplasia. DESIGN: This study was conducted as part of the service evaluation audit. SETTING: Tertiary referral centre. PATIENTS: All patients with dysplastic Barrett's oesophagus referred for RFA were included for analysis. White light high-resolution endoscopy (HRE), autofluorescence imaging and narrow band imaging were sequentially performed...
January 2016: Frontline Gastroenterology
Shinichiro Nakada, Jun Kawamoto, Takuya Yoichi, Kimio Shinoda, Emi Ishigami, Ryotaro Teranaka, Masaru Miyazaki
A 71-year-old man was admitted to our hospital because of abdominal pain. An upper gastrointestinal endoscopy revealed a type 3 tumor in the lesser curvature of the gastric body. A computed tomography (CT) scan showed synchronous liver metastasis in liver S6 and S8, and a large 8a lymph node that could be encased within the common hepatic artery. The patient was diagnosed with gastric cancer with liver metastasis, Stage Ⅳ, and treated with chemotherapy (S-1 plus CDDP). After 3 courses, a CT scan showed that the liver metastasis in S8 was reduced in size...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Ognjan Skrobić, Aleksandar Simić, Nebojša Radovanović, Nenad Ivanović, Marjan Micev, Predrag Peško
OBJECTIVE: HALO radiofrequency ablation (RFA) has been proven as safe and efficient in eradication of both non- and dysplastic Barrett's esophagus (BE). Definitive post-RFA treatment is yet to be determined. METHODS: RFA was performed in 56 patients with BE, 38 with intestinal metaplasia (IM) and 18 with low-grade dysplasia (LGD), and repeated in case of residual BE. Length of the BE was classified according to C&M criteria. Follow-up included regular upper GI endoscopies with biopsies 6 months, 1 and 2 years after the complete resolution of BE...
September 2016: Surgical Endoscopy
Agoston T Agoston, Adam C Strauss, Parambir S Dulai, Catherine E Hagen, Alona Muzikansky, David I Fudman, Julian A Abrams, David G Forcione, Kunal Jajoo, John R Saltzman, Robert D Odze, Gregory Y Lauwers, Stuart R Gordon, Charles J Lightdale, Richard I Rothstein, Amitabh Srivastava
Radiofrequency ablation (RFA), with or without endoscopic mucosal resection (EMR), is a safe, effective, and durable treatment option for Barrett esophagus (BE)-associated dysplasia (DYS), but few studies have identified predictors of treatment failure in BE-associated intramucosal adenocarcinoma (IMC). The aim of this study was to determine the rate of IMC eradication when using RFA±EMR and to identify clinical and pathologic predictors of treatment failure. A retrospective review of medical records and a central review of index histologic parameters were performed for 78 patients who underwent RFA±EMR as the primary treatment for biopsy-proven IMC at 4 academic tertiary medical centers...
April 2016: American Journal of Surgical Pathology
Kai Xu, Yongliang Chen, Mingyi Chen, Wenzhi Zhang, Yanbin Wang, Wenbin Ji, Hongguang Wang, Xianlei Xin, Jian Feng, Ying Li, Li Yan
OBJECTIVE: To investigate the clinical features, diagnostic and therapeutic methods of primary hepatic neuroendocrine carcinoma. METHODS: The clinicopathological data of fourteen patients with primary hepatic neuroendocrine carcinoma confirmed by pathology were analyzed retrospectively and related literatures were reviewed. RESULTS: The fourteen patients, including eight males and six females, had an age range of 23-58 years (mean 45.9 years)...
June 2015: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
Dirk W Schölvinck, Hannah T Künzli, Christine Kestens, Peter D Siersema, Frank P Vleggaar, Marcia Irene Canto, Hilary Cosby, Julian A Abrams, Charles J Lightdale, Elizabeth Tejeda-Ramirez, Steven R DeMeester, Christine L Greene, Blair A Jobe, Jeff Peters, Jacques J G H M Bergman, Bas L A M Weusten
BACKGROUND AND AIMS: Currently, eradication of Barrett's epithelium is preferably achieved using radiofrequency ablation (RFA) or spray cryoablation (SCA). However, both modalities suffer from drawbacks such as the need for sizing, multiple deployment steps, large controller units (RFA), imprecise dosing and need for gas-venting (SCA). The new Cryoballoon Focal Ablation System (CbFAS) may address these limitations. This study assessed the safety, feasibility, and dose response of the CbFAS in patients with flat Barrett's epithelium with or without dysplasia...
December 2015: Endoscopy
Darina Kohoutova, Rehan Haidry, Matthew Banks, Stephen Bown, Vinay Sehgal, Mohammed Adil Butt, David Graham, Sally Thorpe, Marco Novelli, Manuel Rodriguez-Justo, Laurence Lovat
OBJECTIVE: Photodynamic therapy (PDT) and radiofrequency ablation (RFA) are effective non-surgical options for the treatment of Barrett's esophagus (BE) associated neoplasia. Development of subsquamous intestinal metaplasia after successful PDT and/or RFA is a recognized phenomenon; however, the occurrence of neoplasia arising from buried glands is a rare complication. METHODS: This is a prospective case series of patients treated with PDT and/or RFA from 1999 to 2014 at University College London Hospital for neoplasia associated with BE, whose outcomes were analyzed retrospectively...
2015: Scandinavian Journal of Gastroenterology
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