The efficacy and safety of argon plasma coagulation therapy in Barrett's esophagus☆,☆☆
Section snippets
PATIENTS AND METHODS
Patients with circumferential Barrett's esophagus (columnar mucosa found at endoscopy and specialized intestinal metaplasia on biopsy) 2 to 5 cm long were prospectively recruited for the study. Patients were excluded if they had evidence of dysplasia on biopsy, known cardiac disease, or lung disease requiring supplemental oxygen or any other contraindication to repeated endoscopy and extensive mucosal sampling. Each patient gave informed consent as approved by the human subjects committee of
RESULTS
Ten patients, all men, with Barrett's esophagus were included. Nine patients completed the study. The mean age was 51.1 ± 1.9 years. The mean length of Barrett's esophagus was 3.6 ± 0.4 cm. The patient who discontinued the study did so because of discomfort during the initial treatment session.
Eight of the 9 patients who completed the study underwent 24-hour ambulatory pH monitoring. One patient could not tolerate passage of the probe. Four patients underwent 24-hour pH studies before APC
DISCUSSION
The incidence of adenocarcinoma among persons with Barrett's esophagus is estimated to be 30 to 40 times that of the healthy population.1, 24, 25, 26 The largest prospective evaluation reported to date found an incidence of adenocarcinoma equaling 1 per 208 patient-years of follow-up study.27 The intestinal metaplasia of Barrett's esophagus is thought to arise from abnormal cell differentiation after injury caused by acid reflux. The current working hypothesis is that putative esophageal stem
References (32)
- et al.
Increasing incidence of adenocarcinoma of the esophagus and esophagogastric junction
Gastroenterology
(1993) - et al.
Effect of antireflux operation on Barrett's mucosa
Ann Thorac Surg
(1990) - et al.
Squamous islands in Barrett's esophagus: what lies underneath?
Am J Gastroenterol
(1998) - et al.
Photodynamic therapy for treatment of early adenocarcinoma in Barrett's esophagus
Gastrointest Endosc
(1993) - et al.
Barrett's esophagus: photodynamic therapy for ablation of dysplasia reduction of specialized mucosa, and treatment of superficial esophageal cancer
Gastrointest Endosc
(1995) - et al.
Photodynamic therapy for Barrett's esophagus
Gastrointest Endosc Clin N Am
(1997) - et al.
Initial results using low-dose photodynamic therapy in the treatment of Barrett's esophagus
Gastrointest Endosc
(1995) - et al.
Reversal of Barrett's esophagus with acid suppression and multipolar electrocoagulation: preliminary results
Gastrointest Endosc
(1996) - et al.
Adenocarcinoma and Barrett's esophagus: an overrated risk
Gastroenterology
(1984) - et al.
Repeat laser therapy of recurrent Barrett's epithelium: success with anacidity [letter]
Gastrointest Endosc
(1995)
Reversal of Barrett's esophagus with multipolar electrocoagulation: is acid suppression important [abstract]?
Gastrointest Endosc
Barrett's esophagus
N Engl J Med
Barrett's esophagus: a prevalent, occult complication of gastroesophageal reflux disease
Gastroenterology
Rising incidence of adenocarcinoma of the esophagus and gastric cardia
JAMA
Effect of up to 3 years of high-dose lansoprazole on Barrett's esophagus
Am J Gastroenterol
Barrett's esophagus, comparison of benign and malignant cases
Ann Surg
Cited by (88)
Biology of cancer; from cellular and molecular mechanisms to developmental processes and adaptation
2022, Seminars in Cancer BiologyCitation Excerpt :Combination therapies have been designed both to remove (surgically) Barrett's mucosa and to inhibit (pharmacologically) gastric acid secretion. In such cases, contextual instructions of supracellular control regenerate a normal esophageal mucosa, not an intestinal neomucosa, because acid aggression is suppressed and intestinal neomucosa is no longer necessary [304,306–308]. In gastric diseases, the proton pump inhibitors block the secretion of gastric acid from gastric parietal cells.
Barrett's esophagus: What do we need to know?
2020, Disease-a-MonthRadiofrequency ablation of symptomatic cervical inlet patch using a through-the-scope device: a pilot study
2016, Gastrointestinal EndoscopyArgon Plasma Coagulation in Barrett's Esophagus
2013, Video Journal and Encyclopedia of GI EndoscopyAdvances in endoluminal therapy for esophageal cancer
2013, Gastrointestinal Endoscopy Clinics of North America
- ☆
Reprint requests: Francisco C. Ramirez, MD, Chief, Gastroenterology, Carl T. Hayden VA Medical Center, 650 E. Indian School Rd., Phoenix, AZ 85012.
- ☆☆
37/1/98173