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Endoscopic thermoablation with argon plasma coagulation (APC) for Barrett’s oesophagus is most effective for shorter segments but “buried” glands do occur. APC should remain in the area of experimental clinical studies
Barrett’s oesophagus (BO) is undoubtedly associated with an increased risk of adenocarcinoma of the oesophagus.1 Now that therapeutic endoscopy techniques have improved, it is therefore tempting to ablate Barrett’s intestinal metaplasia in order to decrease the risk of tumour development. However, ablation therapy is still controversial, especially for patients having no dysplasia, due to: (1) their low risk of cancer; (2) the risk associated with the technique of ablation; and (3) the fact that we do not know if Barrett’s ablation will really decrease the risk of cancer in the long term in an individual patient.
The rationale for current ablative therapy began with the observation that destruction or ablation of intestinal metaplasia associated with acid suppression results in its rapid replacement by a squamous epithelium.2 Several groups of investigators have performed clinical studies evaluating the effectiveness of BO ablation associated with proton …