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Radiofrequency in Barrett

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https://www.readbyqxmd.com/read/28870046/-the-chinese-consensus-for-screening-diagnosis-and-management-of-barrett-s-esophagus-and-early-adenocarcinoma-2017-wanning
#1
(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
#2
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
#3
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
#4
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...
August 17, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28770555/efficacy-of-liquid-nitrogen-cryotherapy-for-barrett-s-esophagus-after-endoscopic-resection-of-intramucosal-cancer-a-multicenter-study
#5
Arvind J Trindade, Douglas K Pleskow, Neil Sengupta, Shivangi Kothari, Sumant Inamdar, Joshua Berkowitz, Vivek Kaul
BACKGROUND AND AIM: Liquid nitrogen cryotherapy (LNC) allows increased depth of ablation compared to radiofrequency ablation (RFA) in Barrett's esophagus (BE). Expert centers may use LNC over RFA to ablate Barrett's esophagus after endoscopic resection of intramucosal cancer (IMCA). The aim of our study was to: 1) evaluate the safety and efficacy of LNC ablation in patients with BE and IMCA and 2) to evaluate the progression to invasive disease despite therapy. METHODS: This was a multicenter, retrospective study of consecutive patients with BE who received LNC following endoscopic mucosal resection (EMR) of IMCA...
August 2, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28752023/trends-in-the-management-of-small-renal-masses-a-survey-of-members-of-the-endourological-society
#6
Anand Mohapatra, Aaron M Potretzke, John Weaver, Barrett G Anderson, Joel Vetter, Robert S Figenshau
Treatment modalities for small renal masses (SRMs) include open or minimally invasive radical or partial nephrectomy, and laparoscopic or percutaneous ablations. Members of the Endourological Society were surveyed to evaluate how practitioner and clinical practice characteristics may be associated with the management of SRMs over time. The survey assessed characteristics of urologists (recency of residency and fellowship training, clinical practice type and location, and treatment modalities available) and their management of SRMs over the past year and over the course of the year 5 years prior...
2017: Journal of Kidney Cancer and VHL
https://www.readbyqxmd.com/read/28720474/nitrous-oxide-cryotherapy-for-treatment-of-esophageal-squamous-cell-neoplasia-initial-multicenter-international-experience-with-a-novel-portable-cryoballoon-ablation-system-with-video
#7
Marcia Irene Canto, Julian A Abrams, Hannah T Künzli, Bas Weusten, Yoshihiro Komatsu, Blair A Jobe, Charles J Lightdale
BACKGROUND AND AIMS: Early esophageal squamous cell neoplasia (ESCN) can be successfully treated by EMR, endoscopic submucosal dissection (ESD), or radiofrequency ablation. A new portable, battery-powered cryotherapy system using nitrous oxide (cryoballoon focal ablation system [CbFAS]) has been used for Barrett's esophagus. It consists of a small hand-held device containing liquid nitrous oxide, which converts to gas within a low-pressure-compliant through-the-scope balloon and freezes targeted mucosa in contact with the balloon...
July 16, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28579538/late-recurrence-of-barrett-s-esophagus-after-complete-eradication-of-intestinal-metaplasia-is-rare-final-report-from-ablation-in-intestinal-metaplasia-containing-dysplasia-trial
#8
RANDOMIZED CONTROLLED TRIAL
Cary C Cotton, W Asher Wolf, Bergein F Overholt, Nan Li, Charles J Lightdale, Herbert C Wolfsen, Sarina Pasricha, Kenneth K Wang, Nicholas J Shaheen
BACKGROUND & AIMS: The goal of treatment for Barrett's esophagus (BE) with dysplasia is complete eradication of intestinal metaplasia (CEIM). The long-term durability of CEIM has not been well characterized, so the frequency and duration of surveillance are unclear. We report results from a 5-year follow-up analysis of patients with BE and dysplasia treated by radiofrequency ablation (RFA) in the randomized controlled Ablation of Intestinal Metaplasia Containing Dysplasia (AIM) trial...
September 2017: Gastroenterology
https://www.readbyqxmd.com/read/28577770/radiofrequency-ablation-of-barrett-s-esophagus-efficacy-complications-and-durability
#9
REVIEW
Kavel Visrodia, Liam Zakko, Kenneth K Wang
In the last decade, radiofrequency ablation in combination with endoscopic mucosal resection has simplified and improved the treatment of Barrett's esophagus. These treatments not only reduced the progression of dysplastic Barrett's esophagus to esophageal adenocarcinoma but also decreased treatment-related complications. More recent data from larger series with extended follow-up periods are emerging to refine expectations in patients treated with radiofrequency ablation. Although most patients achieve eradication of neoplasia and intestinal metaplasia, in the long-term a substantial portion of patients develop recurrent disease...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28573176/recurrence-of-intestinal-metaplasia-and-early-neoplasia-after-endoscopic-eradication-therapy-for-barrett-s-esophagus-a-systematic-review-and-meta-analysis
#10
Larissa L Fujii-Lau, Birtukan Cinnor, Nicholas Shaheen, Srinivas Gaddam, Srinadh Komanduri, V Raman Muthusamy, Ananya Das, Robert Wilson, Violette C Simon, Vladimir Kushnir, Daniel Mullady, Steven A Edmundowicz, Dayna S Early, Sachin Wani
BACKGROUND:  Conflicting data exist with regard to recurrence rates of intestinal metaplasia (IM) and dysplasia after achieving complete eradication of intestinal metaplasia (CE-IM) in Barrett's esophagus (BE) patients. AIM:  (i) To determine the incidence of recurrent IM and dysplasia achieving CE-IM and (ii) to compare recurrence rates between treatment modalities [radiofrequency ablation (RFA) with or without endoscopic mucosal resection (EMR) vs stepwise complete EMR (SRER)]...
June 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28572084/ductular-and-proliferative-response-of-esophageal-submucosal-glands-in-a-porcine-model-of-esophageal-injury-and-repair
#11
Leandi Krüger, Liara M Gonzalez, Tiffany A Pridgen, Shannon J McCall, Richard J von Furstenberg, Ivan Harnden, Gwendolyn E Carnighan, Abigail M Cox, Anthony T Blikslager, Katherine S Garman
Esophageal injury is a risk factor for diseases such as Barrett's esophagus (BE) and esophageal adenocarcinoma. To improve understanding of signaling pathways associated with both normal and abnormal repair, animal models are needed. Traditional rodent models of esophageal repair are limited by the absence of esophageal submucosal glands (ESMGs), which are present in the human esophagus. Previously, we identified acinar ductal metaplasia in human ESMGs in association with both esophageal injury and cancer. In addition, the SOX9 transcription factor has been associated with generation of columnar epithelium and the pathogenesis of BE and is present in ESMGs...
September 1, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/28541099/cost-effectiveness-analysis-of-endoscopic-eradication-therapy-for-treatment-of-high-grade-dysplasia-in-barrett-s-esophagus
#12
Alex Filby, Matthew Taylor, Gideon Lipman, Laurence Lovat, Rehan Haidry
AIM: The aim was to evaluate the cost-effectiveness of endoscopic eradication therapy (EET) with combined endoscopic mucosal resection and radiofrequency ablation for the treatment of high-grade dysplasia (HGD) arising in patients with Barrett's esophagus compared with endoscopic surveillance alone in the UK. MATERIALS & METHODS: The cost-effectiveness model consisted of a decision tree and modified Markov model. A lifetime time horizon was adopted with the perspective of the UK healthcare system...
May 25, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/28447001/overview-of-esophageal-cancer
#13
Ghulam Abbas, Mark Krasna
Esophageal cancer is a male-dominant aggressive malignancy and a leading cause of cancer-related mortality worldwide. Squamous cell carcinoma and adenocarcinoma are the two predominant histological subtypes with varying geographical and racial distribution. Globally, squamous cell carcinoma remains the most common histological type. In Western countries, however, adenocarcinoma has become the leading histological subtype, corresponding to a rise in the incidence of obesity, gastro-esophageal reflux disease and Barrett's esophagus...
March 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28441152/cryoablation-in-the-management-of-barrett-s-esophagus
#14
Anouk Overwater, Bas L A M Weusten
PURPOSE OF REVIEW: Providing an overview on types of cryotherapy for esophageal application and their role in the management of Barrett's esophagus. RECENT FINDINGS: Recent studies have involved multiple types of cryotherapy including cryospray techniques that use either liquid nitrogen or carbon dioxide as the cryogenic fluid, and the CryoBalloon focal ablation device that uses nitrous oxide. Overall, studies report cryotherapy to be safe and effective in eradicating Barrett's epithelium...
July 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28421454/quality-indicators-in-endoscopic-ablation-for-barrett-s-esophagus
#15
REVIEW
Samuel Han, Sachin Wani
Barrett's esophagus (BE) is a well-established premalignant condition for esophageal adenocarcinoma (EAC); a cancer that is associated with a poor 5-year survival rate. Several strategies have been explored in the context of reducing the burden of EAC. Endoscopic eradication therapy (EET) is considered the standard of care for the management of patients with BE with dysplasia and early neoplasia; a practice that has been endorsed by all gastroenterology societal guidelines. The effectiveness of EET has been demonstrated in multiple studies and contemporary management includes a combination of endoscopic mucosal resection (EMR) of all visible lesions followed by eradication of the remaining BE using ablative techniques of which radiofrequency ablation (RFA) has the best evidence supporting effectiveness and safety...
June 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28405317/changes-in-gene-expression-of-neo-squamous-mucosa-after-endoscopic-treatment-for-dysplastic-barrett-s-esophagus-and-intramucosal-adenocarcinoma
#16
Angelique Levert-Mignon, Michael J Bourke, Sarah J Lord, Andrew C Taylor, Antony R Wettstein, Melanie Edwards, Natalia K Botelho, Rebecca Sonson, Chatura Jayasekera, Oliver M Fisher, Melissa L Thomas, Finlay Macrae, Damian J Hussey, David I Watson, Reginald V Lord
BACKGROUND: Endoscopic therapy, including by radiofrequency ablation (RFA) or endoscopic mucosal resection (EMR), is first line treatment for Barrett's esophagus (BE) with high-grade dysplasia (HGD) or intramucosal cancer (IMC) and may be appropriate for some patients with low-grade dysplasia (LGD). OBJECTIVE: The purpose of this study was to investigate the molecular effects of endotherapy. METHODS: mRNA expression of 16 genes significantly associated with different BE stages was measured in paired pre-treatment BE tissues and post-treatment neo-squamous biopsies from 36 patients treated by RFA (19 patients, 3 IMC, 4 HGD, 12 LGD) or EMR (17 patients, 4 IMC, 13 HGD)...
February 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28374819/disease-progression-in-barrett-s-low-grade-dysplasia-with-radiofrequency-ablation-compared-with-surveillance-systematic-review-and-meta-analysis
#17
REVIEW
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
https://www.readbyqxmd.com/read/28353175/current-concepts-in-treatment-of-barrett-s-esophagus-with-and-without-dysplasia
#18
Francisco Schlottmann, Marco G Patti
BACKGROUND: Around 10-15% of patients with gastroesophageal reflux disease will develop Barrett's esophagus (BE). The development of novel endoscopic modalities has changed the management of BE in the last decade. AIM: The aim of this study was to review the current evidence for the treatment of BE with and without dysplasia. RESULTS: In patients with BE without dysplasia, antireflux surgery should not be suggested as a modality to prevent the malignant transformation of BE, but its indications should be the same as for other patients with gastroesophageal reflux...
August 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28303613/feasibility-of-liquid-nitrogen-cryotherapy-after-failed-radiofrequency-ablation-for-barrett-s-esophagus
#19
Arvind J Trindade, Sumant Inamdar, Shivangi Kothari, Joshua Berkowitz, Matthew McKinley, Vivek Kaul
BACKGROUND AND AIM: Radiofrequency ablation (RFA) for dysplastic Barrett's esophagus (BE) is highly effective. RFA failures are infrequent but can be a challenging cohort to manage. There are limited data on the feasibility of liquid nitrogen cryospray ablation for complete eradication of dysplasia (CE-D) and/or intestinal metaplasia (CE-IM) after RFA has failed to achieve CE-IM in patients with dysplastic BE. METHODS: This is a retrospective review from two medical centers of prospectively maintained databases looking at patients that underwent liquid nitrogen cryospray ablation for refractory intestinal metaplasia post failed RFA...
March 16, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28256346/past-present-and-future-of-barrett-s-oesophagus
#20
REVIEW
W K Tan, M di Pietro, R C Fitzgerald
Barrett's oesophagus is a condition which predisposes towards development of oesophageal adenocarcinoma, a highly lethal tumour which has been increasing in incidence in the Western world over the past three decades. There have been tremendous advances in the field of Barrett's oesophagus, not only in diagnostic modalities, but also in therapeutic strategies available to treat this premalignant disease. In this review, we discuss the past, present and future of Barrett's oesophagus. We describe the historical and new evolving diagnostic criteria of Barrett's oesophagus, while also comparing and contrasting the British Society of Gastroenterology guidelines, American College of Gastroenterology guidelines and International Benign Barrett's and CAncer Taskforce (BOBCAT) for Barrett's oesophagus...
July 2017: European Journal of Surgical Oncology
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