Long-term follow-up after complete ablation of Barrett's esophagus with argon plasma coagulation

被引:37
|
作者
Madisch, Ahmed [1 ]
Miehlke, Stephan [1 ]
Bayerdoerffer, Ekkehard [2 ]
Wiedemann, Birgit
Antos, David [3 ]
Sievert, Anke
Vieth, Michael [4 ]
Stolte, Manfred [5 ]
Schulz, Heinrich
机构
[1] Tech Univ Hosp, Dept Med 1, D-01307 Dresden, Germany
[2] Univ Hosp Marburg, Dept Hematol & Oncol, Marburg, Germany
[3] Univ Hosp Munich, Clin Pediat Dis, Munich, Germany
[4] Univ Magdeburg, Inst Pathol, D-39106 Magdeburg, Germany
[5] Klinikum Bayreuth, Inst Pathol, Bayreuth, Germany
关键词
Barrett's esophagus; Argon plasma coagulation; Esophageal adenocarcinoma;
D O I
10.3748/wjg.v11.i8.1182
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
AIM: To report the long-term outcome of patients after complete ablation of non-neoplastic Barrett's esophagus (BE) with respect to BE relapse and development of intraepithelial neoplasia or esophageal adenocarcinoma. METHODS: In 70 patients with histologically proven nonneoplastic BE, complete BE ablation was achieved by argon plasma coagulation (APC) and high-dose proton pump inhibitor therapy (120 mg omeprazole daily). Sixty-six patients (94.4%) underwent further surveillance endoscopy. At each surveillance endoscopy four-quadrant biopsies were taken from the neo-squamous epithelium at 2 cm intervals depending on the pre-treatment length of BE mucosa beginning at the neo-Z-line, and from any endoscopically suspicious lesion. RESULTS: The median follow-up of 66 patients was 51 mo (range 9-85 mo) giving a total of 280.5 patient years. A mean of 6 biopsies were taken during surveillance endoscopies. In 13 patients (19.7%) tongues or islands suspicious for BE were found during endoscopy. In 8 of these patients (12.1%) non-neoplastic BE relapse was confirmed histologically giving a histological relapse rate of 3% per year. In none of the patients, intraepithelial neoplasia nor an esophageal adenocarcinoma was detected. Logistic regression analysis identified endoscopic detection of islands or tongues as the only positive predictor of BE relapse (P = 0.0004). CONCLUSION: The long-term relapse rate of non-neoplastic BE following complete ablation with high-power APC is low (3% per year). (C) 2005 The WJG Press and Elsevier Inc. All rights reserved.
引用
收藏
页码:1182 / 1186
页数:5
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