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Radiofrequency in Barrett

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https://www.readbyqxmd.com/read/28205741/p-44-radiofrequency-ablation-in-treatment-of-barrett-s-esophagus-also-in-esophageal-atresia
#1
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/28042239/oral-steroid-prophylaxis-is-effective-in-preventing-esophageal-strictures-after-large-endoscopic-resection
#2
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-at-increased-risk-for-progression-to-neoplasia
#3
Lucas C Duits, M 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 (BE), 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 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...
December 21, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27999692/polypoid-dysplasia-in-barrett-s-esophagus-diagnosis-management-and-very-different-outcomes-in-two-consecutive-cases
#4
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
#5
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/27993667/convective-radiofrequency-water-vapor-thermal-therapy-with-rez%C3%A5-m-system-durable-two-year-results-of-randomized-controlled-and-prospective-crossover-studies-for-treatment-of-lower-urinary-tract-symptoms-due-to-benign-prostatic-hyperplasia
#6
Claus G Roehrborn, Steven N Gange, Marc C Gittelman, Kenneth A Goldberg, Kalpesh Patel, Neal D Shore, Richard M Levin, Michael Rousseau, J Randolf Beahrs, Jed Kaminetsky, Barrett E Cowan, Christopher H Cantrill, Lance A Mynderse, James C Ulchaker, Thayne R Larson, Christopher M Dixon, Kevin T McVary
PURPOSE: To report two-year outcomes of a multi-center randomized controlled trial plus one-year results of a crossover trial after treatment with convective radiofrequency water vapor thermal energy for lower urinary tract symptoms due to benign prostatic hyperplasia. MATERIALS AND METHODS: 197 men at least 50 years old with International Prostate Symptom Scores 13 or greater, maximum flow rate of 15 ml per second or less and prostate size 30 to 80 cc were randomized 2:1 between thermal therapy with the Rezūm® System and control...
December 16, 2016: Journal of Urology
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
#7
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
#8
K N Phoa, W D Rosmolen, B L A M Weusten, R Bisschops, E J Schoon, S Das, K Ragunath, G Fullarton, M DiPietro, N Ravi, J G P Tijssen, M G W Dijkgraaf, J J G H M Bergman
BACKGROUND & 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 (HGD) 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
#9
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
#10
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/27807370/role-of-endoscopy-in-early-oesophageal-cancer
#11
REVIEW
Jayan Mannath, Krish Ragunath
Incidence of oesophageal adenocarcinoma has increased exponentially in the West over the past few decades. Following detection of advanced cancers, 5-year survival rates remain bleak, making identification of early neoplasia, which has a better outcome, important. Detection of subtle oesophageal lesions during endoscopy can be challenging, and advanced imaging techniques might improve their detection. High-definition endoscopy has become a standard in most endoscopy centres, and this technology probably provides better delineation of mucosal features than standard-definition endoscopy...
December 2016: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27725648/clinical-outcomes-following-recurrence-of-intestinal-metaplasia-after-successful-treatment-of-barrett-s-esophagus-with-radiofrequency-ablation
#12
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/27681974/barrett-s-oesophagus-epidemiology-diagnosis-and-clinical-management
#13
David C Whiteman, Bradley J Kendall
Barrett's oesophagus is a condition characterised by partial replacement of the normal squamous epithelium of the lower oesophagus by a metaplastic columnar epithelium containing goblet cells (intestinal metaplasia). Barrett's oesophagus is important clinically because those afflicted are predisposed to oesophageal adenocarcinoma. Prevalence surveys suggest that up to 2% of the population may be affected; most will be unaware of their diagnosis. Risk factors include age, male sex, gastro-oesophageal acid reflux, central obesity and smoking...
October 3, 2016: Medical Journal of Australia
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
#14
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
#15
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
#16
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
https://www.readbyqxmd.com/read/27573769/endoscopic-treatment-of-early-barrett-s-neoplasia-expanding-indications-new-challenges
#17
Oliver Pech
Endoscopic therapy of early Barrett's neoplasia is nowadays the treatment of choice and recommended over surgery in most current guidelines. Recent data suggest radiofrequency ablation of low-grade intraepithelial neoplasia when confirmed by an expert pathologist. Endoscopic therapy of high-grade intraepithelial neoplasia and mucosal Barrett's adenocarcinoma consists of two steps: first endoscopic resection of all visible lesions, and second ablation of the remaining flat Barrett's mucosa to reduce the rate of recurrences and metachronous neoplasia...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27540572/recurrent-intestinal-metaplasia-at-the-gastroesophageal-junction-following-endoscopic-eradication-of-dysplastic-barrett-s-esophagus-may-not-be-benign
#18
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
https://www.readbyqxmd.com/read/27391867/current-treatment-options-for-esophageal-diseases
#19
Jan Martínek, Jun-Ichi Akiyama, Zuzana Vacková, Manuele Furnari, Edoardo Savarino, Teus J Weijs, Elen Valitova, Sylvia van der Horst, Jelle P Ruurda, Lucas Goense, George Triadafilopoulos
Exciting new developments-pharmacologic, endoscopic, and surgical-have arisen for the treatment of many esophageal diseases. Refractory gastroesophageal reflux disease presents a therapeutic challenge, and several new options have been proposed to overcome an insufficient effectiveness of proton pump inhibitors. In patients with distal esophageal spasm, drugs and endoscopic treatments are the current mainstays of the therapeutic approach. Treatment with proton pump inhibitors (or antireflux surgery) should be considered in patients with Barrett's esophagus, since a recent meta-analysis demonstrated a 71% reduction in risk of neoplastic progression...
October 2016: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/27373671/radiofrequency-ablation-of-symptomatic-cervical-inlet-patch-using-a-through-the-scope-device-a-pilot-study
#20
Jason Mark Dunn, Guiping Sui, Angela Anggiansah, Terence Wong
BACKGROUND AND AIMS: The cervical inlet patch (CIP) is an area of heterotopic gastric mucosa at the proximal esophagus, which can secrete both acid and mucus. Attributable symptoms include chronic globus sensation and sore throat. Previous studies have demonstrated improvement in symptoms after ablation using argon plasma coagulation. Our aim was to assess a through-the-scope radiofrequency ablation (RFA) catheter for ablation of symptomatic CIP. METHODS: Ten patients with endoscopically and histologically proven CIP and symptoms of globus or sore throat were included in the study...
December 2016: Gastrointestinal Endoscopy
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