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Endoscopic therapy of Barrett’s: what more do we need to know?
  1. J-L Van Laethem,
  2. J Devière
  1. Department of Gastroenterology, Erasme University Hospital, Brussels, Belgium
  1. Correspondence to:
    Dr J-L Van Laethem
    Department of Gastroenterology, Erasme University Hospital, 808 Route de Lennik, Brussels, Belgium; jvlaetheulb.ac.be

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Results emerging from endoscopic treatments to ablate Barrett’s oesophagus indicate that APC alone or ALA-PDT in combination with APC achieves complete clearance of Barrett’s epithelium in approximately two thirds of patients

Over the past few years, different endoscopic ablative techniques have been used in combination with antireflux therapy with the aim of reversing Barrett’s oesophagus and replacing it with squamous epithelium. The end goal of these procedures is to impact directly on the risk of tumour development.

To date, most of the published results on ablative therapy in Barrett’s oesophagus have dealt with a single treatment modality, and long term results as well as the real impact on the course of the condition remain unanswered.

The most widely used and studied procedures are photochemical (that is, photodynamic therapy (PDT) using Photofin or more recently 5-aminolevulinic acid (5-ALA)1,2) and thermal (that is, argon plasma coagulation (APC)).3

The study by Hage and colleagues,4 in this issue of Gut, is the first to compare two modalities [see page 785]. This …

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