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rfa endoscopy

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...
October 11, 2016: 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...
September 27, 2016: 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
Aaron J Small, James L Araujo, Cadman L Leggett, Aaron H Mendelson, Anant Agarwalla, Julian A Abrams, Charles J Lightdale, Timothy C Wang, Prasad G Iyer, Kenneth K Wang, Anil K Rustgi, Gregory G Ginsberg, Kimberly A Forde, Phyllis A Gimotty, James D Lewis, Gary W Falk, Meenakshi Bewtra
BACKGROUND & AIMS: Barrett's esophagus (BE) with low-grade dysplasia (LGD) can progress to high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC). Radiofrequency ablation (RFA) has been shown to be an effective treatment for LGD in clinical trials, but its effectiveness in clinical practice is unclear. We compared the rate of progression of LGD after RFA with endoscopic surveillance alone in routine clinical practice. METHODS: We performed a retrospective study of patients who either underwent RFA (n = 45) or surveillance endoscopy (n = 125) for LGD, confirmed by at least 1 expert pathologist, from October 1992 through December 2013 at 3 medical centers in the United States...
September 2015: Gastroenterology
Cary C Cotton, W Asher Wolf, Sarina Pasricha, Nan Li, Ryan D Madanick, Melissa B Spacek, Kathleen Ferrell, Evan S Dellon, Nicholas J Shaheen
BACKGROUND: Radiofrequency ablation (RFA) is a safe and effective treatment for Barrett's esophagus (BE) that results in high rates of complete eradication of intestinal metaplasia (CEIM). However, recurrence is common after CEIM, and surveillance endoscopy is recommended. Neither the anatomic location nor the endoscopic appearance of these recurrences is well-described. OBJECTIVE: Describe the location of histologic specimens positive for recurrence after CEIM and the testing performance of endoscopic findings for the histopathologic detection of recurrence...
2015: Gastrointestinal Endoscopy
Gianmattia Del Genio, Federica Del Genio, Pietro Schettino, Paolo Limongelli, Salvatore Tolone, Luigi Brusciano, Manuela Avellino, Chiara Vitiello, Giovanni Docimo, Angelo Pezzullo, Ludovico Docimo
Squamous papilloma of the esophagus is a rare benign lesion of the esophagus. Radiofrequency ablation is an established endoscopic technique for the eradication of Barrett esophagus. No cases of endoscopic ablation of esophageal papilloma by radiofrequency ablation (RFA) have been reported. We report a case of esophageal papilloma successfully treated with a single session of radiofrequency ablation. Endoscopic ablation of the lesion was achieved by radiofrequency using a new catheter inserted through the working channel of endoscope...
March 16, 2015: World Journal of Gastrointestinal Endoscopy
K Nadine Phoa, Roos E Pouw, Raf Bisschops, Oliver Pech, Krish Ragunath, Bas L A M Weusten, Brigitte Schumacher, Bjorn Rembacken, Alexander Meining, Helmut Messmann, Erik J Schoon, Liebwin Gossner, Jayan Mannath, C A Seldenrijk, Mike Visser, Toni Lerut, Stefan Seewald, Fiebo J ten Kate, Christian Ell, Horst Neuhaus, Jacques J G H M Bergman
OBJECTIVE: Focal endoscopic resection (ER) followed by radiofrequency ablation (RFA) safely and effectively eradicates Barrett's oesophagus (BO) containing high-grade dysplasia (HGD) and/or early cancer (EC) in smaller studies with limited follow-up. Herein, we report long-term outcomes of combined ER and RFA for BO (HGD and/or EC) from a single-arm multicentre interventional study. DESIGN: In 13 European centres, patients with BO ≤ 12 cm with HGD and/or EC on 2 separate endoscopies were eligible for inclusion...
April 2016: Gut
Hendrik Manner, Alexander Neugebauer, Marcus Scharpf, Kirsten Braun, Andrea May, Christian Ell, Falko Fend, Markus D Enderle
BACKGROUND: Thermal ablation for Barrett's oesophagus has widely been established in gastrointestinal endoscopy during the last decade. The mainly used methods of radiofrequency ablation (RFA) and argon-plasma coagulation (APC) carry a relevant risk of stricture formation of up to 5-15%. Newer ablation techniques that are able to overcome this disadvantage would therefore be desirable. The aim of the present study was to compare the depth of tissue injury of the new method of Hybrid-APC versus standard APC within a randomized study in a porcine oesophagus model...
October 2014: United European Gastroenterology Journal
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