AI Article Synopsis
- The study investigates the combined effectiveness of endoscopic resection and radiofrequency ablation (RFA) in managing early neoplasia in Barrett's esophagus (BE) during a single treatment session.
- It involved 40 patients, revealing a high success rate with 95% achieving complete remission of neoplasia and intestinal metaplasia after a median follow-up of 19 months.
- The approach was generally safe, though 33% experienced stenoses, which were manageable, and 43% achieved complete histologic remission after just one treatment session.
Article Abstract
Background And Aims: The management of early neoplasia in Barrett's esophagus (BE) requires endoscopic resection of visible lesions, followed by radiofrequency ablation (RFA) of the remaining BE. We evaluated the safety and efficacy of combining endoscopic resection and focal RFA in a single endoscopic session in patients with early BE neoplasia.
Methods: This was a retrospective analysis of patients with early BE neoplasia and a visible lesion undergoing combined endoscopic resection and focal RFA in a single session. Consecutive ablation procedures were performed every 8 to 12 weeks until complete endoscopic and histologic eradication of dysplasia and intestinal metaplasia were reached.
Results: Forty patients were enrolled, with a median C1M2 BE segment, a visible lesion with a median diameter of 15 mm, and invasive carcinoma in 68% of cases. Endoscopic resection was performed by using the multiband mucosectomy technique in 80% of cases, and the Barrx(90) catheter (Barrx Medical, Sunnyvale, Calif) was used for focal ablation. When an intention-to-treat analysis was used, both complete remission of all neoplasia and intestinal metaplasia were 95% after a median follow-up of 19 months. Stenoses occurred in 33% of cases and were successfully managed with a median number of 2 dilations. In 43% of patients, 1 single-session treatment resulted in complete histologic remission of intestinal metaplasia.
Conclusions: Combining endoscopic resection and focal RFA in a single session appears to be effective. Less-aggressive RFA regimens could limit the adverse event rates.
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| http://dx.doi.org/10.1016/j.gie.2015.12.034 | DOI Listing |
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