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Radiofrequency in Barrett

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https://www.readbyqxmd.com/read/29777441/mucosal-ablation-in-patients-with-barrett-s-esophagus-fry-or-freeze
#1
REVIEW
Kavel Visrodia, Liam Zakko, Kenneth K Wang
The management of Barrett's esophagus and early esophageal adenocarcinoma has shifted away from esophagectomy and toward endoscopic techniques, including endoscopic resection and ablative therapies. The most commonly used ablative therapies are radiofrequency ablation and cryotherapy. Radiofrequency ablation has risen to the top of the management algorithm due to its favorable safety profile and established track record of efficacy in patients with dysplastic Barrett's. Cryotherapy offers early promise as an alternatively safe and effective ablative modality...
May 17, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29720850/diagnosis-and-treatment-of-superficial-esophageal-cancer
#2
REVIEW
Maximilien Barret, Frédéric Prat
Endoscopy allows for the screening, early diagnosis, treatment and follow up of superficial esophageal cancer. Endoscopic submucosal dissection has become the gold standard for the resection of superficial squamous cell neoplasia. Combinations of endoscopic mucosal resection and radiofrequency ablation are the mainstay of the management of Barrett's associated neoplasia. However, protruded, non-lifting or large lesions may be better managed by endoscopic submucosal dissection. Novel ablation tools, such as argon plasma coagulation with submucosal lifting and cryoablation balloons, are being developed for the treatment of residual Barrett's esophagus, since iatrogenic strictures still hamper the development of extensive circumferential resections in the esophagus...
May 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29689573/systematic-review-and-meta-analysis-of-the-effectiveness-of-radiofrequency-ablation-in-low-grade-dysplastic-barrett-s-esophagus
#3
Gargi Pandey, Mubashir Mulla, Wyn G Lewis, Antonio Foliaki, David S Y Chan
BACKGROUND:  Barrett's esophagus (BE) is a premalignant condition characterized by replacement of the esophageal lining with metastatic columnar epithelium, and its management when complicated by low grade dysplasia (LGD) is controversial. This systematic review and meta-analysis aimed to determine the efficacy of radiofrequency ablation (RFA) in patients with LGD. METHODS:  MEDLINE, EMBASE, and Web of Science were searched for studies including patients with BE-associated LGD receiving RFA (January 1990 to May 2017)...
April 24, 2018: Endoscopy
https://www.readbyqxmd.com/read/29671157/natural-history-of-the-post-ablation-esophagus
#4
REVIEW
Craig C Reed, Nicholas J Shaheen
Endoscopic ablative therapy including radiofrequency ablation (RFA) represents the preferred management strategy for dysplastic Barrett's esophagus (BE) and appears to diminish the risk of developing esophageal adenocarcinoma (EAC). Limited data describe the natural history of the post-ablation esophagus. Recent findings demonstrate that recurrent intestinal metaplasia (IM) following RFA is relatively frequent. However, dysplastic BE and EAC subsequent to the complete eradication of intestinal metaplasia (CEIM) are uncommon...
April 18, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29655833/development-of-evidence-based-surveillance-intervals-following-radiofrequency-ablation-of-barrett-s-esophagus
#5
Cary C Cotton, Rehan Haidry, Aaron P Thrift, Laurence Lovat, Nicholas J Shaheen
BACKGROUND AND AIMS: Barrett's esophagus (BE) recurs in 25% or more of patients treated successfully with radiofrequency ablation (RFA), so surveillance endoscopy is recommended after complete eradication of intestinal metaplasia (CEIM). The frequency of surveillance is informed only by expert opinion. We aimed to model the incidence of neoplastic recurrence, validate the model in an independent cohort, and propose evidence-based surveillance intervals. METHODS: We collected data from the United States Radiofrequency Ablation Registry (US RFA, 2004-2013) and the United Kingdom National Halo Registry (UK NHR, 2007-2015) to build and validate models to predict the incidence of neoplasia recurrence following initially successful RFA...
April 12, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29588566/radiofrequency-ablation-and-endoscopic-mucosal-in-treatment-of-early-neoplastic-barrett-s-oesophagus
#6
B Callaghan, I Mainie
No abstract text is available yet for this article.
January 2018: Ulster Medical Journal
https://www.readbyqxmd.com/read/29524114/cryotherapy-and-radiofrequency-ablation-for-eradication-of-barrett-s-esophagus-with-dysplasia-or-intramucosal-cancer
#7
Prashanthi N Thota, Zubin Arora, John A Dumot, Gary Falk, Tanmayee Benjamin, John Goldblum, Sunguk Jang, Rocio Lopez, John J Vargo
BACKGROUND AND AIMS: Endoscopic ablation therapy has become the mainstay of treatment of Barrett's associated dysplasia and intramucosal cancer (IMC). The widely available techniques for ablation are radiofrequency ablation (RFA) and cryotherapy. Our aim was to compare eradication rates of metaplasia and dysplasia with both these modalities. PATIENTS AND METHODS: Retrospective review of prospectively collected database of patients who underwent endoscopic therapy for Barrett's dysplasia or IMC from 2006 to 2011 was performed...
May 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29476849/cryotherapy-for-persistent-barrett-s-esophagus-after-radiofrequency-ablation-a-systematic-review-and-meta-analysis
#8
REVIEW
Kavel Visrodia, Liam Zakko, Siddharth Singh, Cadman L Leggett, Prasad G Iyer, Kenneth K Wang
BACKGROUND AND AIMS: A small but significant proportion of patients with Barrett's esophagus (BE) have persistent dysplasia or intestinal metaplasia (IM) after treatment with radiofrequency ablation (RFA). Cryotherapy is a cold-based ablative modality that is increasingly being used in this setting. We aimed to better understand the efficacy of second-line cryotherapy in BE patients with persistent dysplasia or IM after RFA by conducting a systematic review and meta-analysis. METHODS: We performed a systematic literature search of PUBMED, EMBASE, and Web of Sciences through September 1, 2017...
February 21, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29351156/liquid-nitrogen-spray-cryotherapy-is-associated-with-less-postprocedural-pain-than-radiofrequency-ablation-in-barrett-s-esophagus-a-multicenter-prospective-study
#9
Sanjeev S Solomon, Shivangi Kothari, George B Smallfield, Sumant Inamdar, Peter Stein, Viviana A Rodriguez, Adam P Sima, Krystle Bittner, Alvin M Zfass, Vivek Kaul, Arvind J Trindade
GOALS AND BACKGROUND: Two common endoscopic therapies for eradication of dysplastic Barrett's esophagus are radiofrequency ablation (RFA) and liquid nitrogen spray cryotherapy (LNC). There is no data comparing postprocedural pain. This study aimed to compare the incidence of postprocedural pain between the 2 ablation modalities. METHODS: This is a multicenter prospective study in which pain intensity scores and the presence of dysphagia were assessed immediately before and after treatment, 48 hours posttreatment and at 3 weeks posttreatment using validated instruments...
January 18, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29250106/update-on-the-management-of-barrett-s-esophagus-in-austria
#10
M Riegler, I Kristo, M Nikolic, E Rieder, S F Schoppmann
Background: Barrett's esophagus (BE) is the premalignant manifestation of gastroesophageal reflux disease (GERD). Radiofrequency ablation (RFA) with and without endoscopic resection (ER) is a novel treatment for BE. Methods: Here we present a single-center update of the recommendations of a recent (June 2015) interdisciplinary expert panel meeting on the management of BE with dysplasia as well as cancer-positive and cancer-negative BE. We conducted a PubMed search of studies published in 2016 and 2017 on the topic of BE and RFA...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
https://www.readbyqxmd.com/read/29211875/the-safety-and-efficacy-of-radiofrequency-ablation-following-endoscopic-submucosal-dissection-for-barrett-s-neoplasia
#11
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...
March 1, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29168641/economic-evaluation-of-endoscopic-radiofrequency-ablation-for-the-treatment-of-dysplastic-barrett-s-esophagus-in-spain
#12
José Miguel Esteban, Pedro González-Carro, Joan B Gornals, Carlos Collados, María Álvarez, Alejandro Pérez-Mitru, Suzan Serip
BACKGROUND AND STUDY AIMS: To assess the cost-effectiveness of introducing endoscopic treatment based on radiofrequency ablation plus endoscopic mucosal resection in selected patients into the standard of care of Barrett's esophagus patients with high-grade dysplasia or low-grade dysplasia in Spain. METHODS: The disease evolution was modeled via a semi-Markov model. The treatment strategies compared included endoscopic treatment based on radiofrequency ablation plus endoscopic mucosal resection and the Standard of Care (esophagectomy or palliative chemoradiotherapy according to disease status for high-grade dysplasia and endoscopic surveillance for low-grade dysplasia)...
March 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29161901/long-term-outcomes-of-the-randomized-controlled-trial-comparing-5-aminolaevulinic-acid-and-photofrin-photodynamic-therapy-for-barrett-s-oesophagus-related-neoplasia
#13
Darina Kohoutova, Rehan Haidry, Matthew Banks, Mohammed Adil Butt, Jason Dunn, Sally Thorpe, Laurence Lovat
OBJECTIVE: Photodynamic therapy (PDT) was used as therapy for early neoplasia associated with Barrett's oesophagus (BE). This is 5-year follow-up of patients enrolled into randomised controlled trial of 5-aminolaevulinic acid (ALA) vs. Photofrin PDT. METHODS: Biopsies were taken from original Barrett's segment during endoscopic follow up using Seattle protocol. Endoscopic mucosal resection (EMR) ± radiofrequency ablation (RFA) was preferred therapy in patients who failed PDT and/or had recurrent neoplasia...
November 21, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29078688/endoscopic-mucosal-ablation-and-resection-of-barrett-s-esophagus-and-related-diseases
#14
REVIEW
Juan A Muñoz-Largacha, Virginia R Litle
The prevalence of gastroesophageal reflux disease as well as the incidence of Barrett's esophagus (BE) has increased in the Western world over the last decades. The chronic reflux of gastric secretions injuries the esophageal mucosa and triggers cellular and molecular changes inducing the transformation of the normal squamous mucosa into columnar metaplastic epithelium. BE is a premalignant condition that can progress to low-grade dysplasia, high-grade dysplasia and ultimately esophageal adenocarcinoma. An early diagnosis of dysplastic changes and the adoption of appropriate therapeutic approaches are essential to improve patient outcomes and survival...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29065436/hot-avulsion-may-be-effective-as-salvage-treatment-for-focal-barrett-s-esophagus-remaining-after-endoscopic-therapy-for-dysplasia-or-early-cancer-a-preliminary-study
#15
Javier Aranda-Hernández, Yuto Shimamura, Andrea Grin, Yugo Iwaya, Maria Cirocco, Gabor Kandel, Gary May, Paul Kortan, Spiro Raftopoulos, Norman Marcon
BACKGROUND AND STUDY AIM:  Both endoscopic mucosal resection (EMR) and radiofrequency ablation (RFA) are used to treat Barrett's esophagus (BE) complicated by dysplasia and intramucosal cancer. However, focal areas of BE can remain after otherwise successful application of these techniques. We report the results of hot avulsion using a hot biopsy forceps to resect these residual focal areas. PATIENTS AND METHODS:  This was a retrospective study from a prospective database in a tertiary reference center from August 2013 to May 2015...
January 2018: Endoscopy
https://www.readbyqxmd.com/read/29036431/longitudinal-outcomes-of-radiofrequency-ablation-versus-surveillance-endoscopy-for-barrett-s-esophagus-with-low-grade-dysplasia
#16
A Kahn, M Al-Qaisi, V T Kommineni, J K Callaway, E S Boroff, G E Burdick, D M Lam-Himlin, M Temkit, M F Vela, F C Ramirez
Radiofrequency ablation of Barrett's esophagus with low-grade dysplasia is recommended in recent American College of Gastroenterology guidelines, with endoscopic surveillance considered a reasonable alternative. Few studies have directly compared outcomes of radiofrequency ablation to surveillance and those that have are limited by short duration of follow-up. This study aims to compare the long-term effectiveness of radiofrequency ablation versus endoscopic surveillance in a large, longitudinal cohort of patients with Barrett's esophagus, and low-grade dysplasia...
September 27, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28870046/-the-chinese-consensus-for-screening-diagnosis-and-management-of-barrett-s-esophagus-and-early-adenocarcinoma-2017-wanning
#17
(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]
https://www.readbyqxmd.com/read/28839898/endoscopic-management-of-barrett-s-and-early-oesophageal-neoplasia
#18
REVIEW
G Lipman, R J Haidry
Barrett's oesophagus (BO) is the only known precursor to oesophageal adenocarcinoma (OAC). Dysplasia and intramucosal cancer arising in BO can safely be treated with endoscopic eradication therapy (EET) due to the low risk of subsequent lymph node metastasis. Treatment at an early stage is paramount due to the ongoing poor prognosis and outcomes of patients with advanced OAC. The mainstay of treatment is endoscopic resection of visible lesions for accurate staging followed by ablation therapy to all remaining columnar-lined epithelium, most commonly with radiofrequency ablation...
April 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28819902/ablation-therapy-for-barrett-s-esophagus-new-rules-for-changing-times
#19
REVIEW
Nour Hamade, Prateek Sharma
PURPOSE OF REVIEW: In this review, we discuss different endoscopic techniques in the eradication of Barrett's esophagus (BE) as well as some controversies in the field of treatment. RECENT FINDINGS: Patients with T1a esophageal adenocarcinoma and BE of high-grade dysplasia should undergo endoscopic ablative therapy. The most studied technique to date is radiofrequency ablation. It can be combined with endoscopic mucosal resection in cases containing nodular and flat lesions...
August 17, 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28816408/endoscopic-treatment-of-barrett-s-esophagus-what-can-we-learn-from-the-western-perspective
#20
REVIEW
Yuto Shimamura, Yugo Iwaya, Kenichi Goda, Christopher W Teshima
The incidence of Barrett's esophagus (BE)-related neoplasia in Western countries has increased in the past several decades and, even in Eastern countries, it appears to be increasing. Endoscopic therapies are the first-line treatment for BE-related neoplasia; however, there is still no standardized treatment strategy. Most of the data have been published from Western countries where the ultimate goal of treatment is complete eradication of BE mucosa removing subtle synchronous lesions and preventing metachronous neoplasia...
March 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
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