Tags

Type your tag names separated by a space and hit enter

Argon beam plasma coagulation as therapy for high-grade dysplasia in Barrett's esophagus.
Clin Gastroenterol Hepatol. 2003 Jul; 1(4):258-63.CG

Abstract

BACKGROUND & AIMS

Patients with high-grade dysplasia in Barrett's esophagus have a high chance of developing adenocarcinoma. Previously these patients have undergone resection, however, the management of patients unsuitable for surgical resection is unclear. We have studied the long-term outcome of patients who have undergone endoscopic Argon ablation for high-grade dysplasia in Barrett's.

METHODS

Twenty-nine patients (median age, 64 yr; range, 43-85 yr) with high-grade dysplasia in Barrett's, who were unfit or had declined surgery, underwent Argon ablation and received follow-up evaluation over 7 years (mean follow-up, 37 mo; range, 7-78 mo). Treatment was stopped once there was no further histologic evidence of dysplasia. The patients then went on to receive a surveillance endoscopy at 3, 6, and 12 months after ablation, then annually thereafter.

RESULTS

High-grade dysplasia responded to treatment in 25 patients (86%); 22 of these had complete regression to neosquamous esophageal mucosa. During follow-up evaluation, no patients died of esophageal adenocarcinoma. Four patients developed cancer, 3 of whom continue with ablation therapy. The fourth patient died of unrelated causes. A single esophageal perforation was the only significant adverse event attributable to therapy. No esophageal strictures occurred and patients returned to normal activity after 24 hours in the majority of cases. Patients who received Argon ablation showed no difference in survival to that of the general population.

CONCLUSIONS

Argon beam ablation for high-grade dysplasia in Barrett's esophagus is an effective and safe treatment, especially in patients unfit for surgical resection.

Authors+Show Affiliations

Department of Upper Gastro-intentinal Surgery, Hope Hospital, Stott Lane, Manchester M6 8HD, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

15017666

Citation

Attwood, Stephen E A., et al. "Argon Beam Plasma Coagulation as Therapy for High-grade Dysplasia in Barrett's Esophagus." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 1, no. 4, 2003, pp. 258-63.
Attwood SE, Lewis CJ, Caplin S, et al. Argon beam plasma coagulation as therapy for high-grade dysplasia in Barrett's esophagus. Clin Gastroenterol Hepatol. 2003;1(4):258-63.
Attwood, S. E., Lewis, C. J., Caplin, S., Hemming, K., & Armstrong, G. (2003). Argon beam plasma coagulation as therapy for high-grade dysplasia in Barrett's esophagus. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 1(4), 258-63.
Attwood SE, et al. Argon Beam Plasma Coagulation as Therapy for High-grade Dysplasia in Barrett's Esophagus. Clin Gastroenterol Hepatol. 2003;1(4):258-63. PubMed PMID: 15017666.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Argon beam plasma coagulation as therapy for high-grade dysplasia in Barrett's esophagus. AU - Attwood,Stephen E A, AU - Lewis,Christopher J, AU - Caplin,Scott, AU - Hemming,Karla, AU - Armstrong,Gordon, PY - 2004/3/16/pubmed PY - 2004/4/24/medline PY - 2004/3/16/entrez SP - 258 EP - 63 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 1 IS - 4 N2 - BACKGROUND & AIMS: Patients with high-grade dysplasia in Barrett's esophagus have a high chance of developing adenocarcinoma. Previously these patients have undergone resection, however, the management of patients unsuitable for surgical resection is unclear. We have studied the long-term outcome of patients who have undergone endoscopic Argon ablation for high-grade dysplasia in Barrett's. METHODS: Twenty-nine patients (median age, 64 yr; range, 43-85 yr) with high-grade dysplasia in Barrett's, who were unfit or had declined surgery, underwent Argon ablation and received follow-up evaluation over 7 years (mean follow-up, 37 mo; range, 7-78 mo). Treatment was stopped once there was no further histologic evidence of dysplasia. The patients then went on to receive a surveillance endoscopy at 3, 6, and 12 months after ablation, then annually thereafter. RESULTS: High-grade dysplasia responded to treatment in 25 patients (86%); 22 of these had complete regression to neosquamous esophageal mucosa. During follow-up evaluation, no patients died of esophageal adenocarcinoma. Four patients developed cancer, 3 of whom continue with ablation therapy. The fourth patient died of unrelated causes. A single esophageal perforation was the only significant adverse event attributable to therapy. No esophageal strictures occurred and patients returned to normal activity after 24 hours in the majority of cases. Patients who received Argon ablation showed no difference in survival to that of the general population. CONCLUSIONS: Argon beam ablation for high-grade dysplasia in Barrett's esophagus is an effective and safe treatment, especially in patients unfit for surgical resection. SN - 1542-3565 UR - https://www.unboundmedicine.com/medline/citation/15017666/Argon_beam_plasma_coagulation_as_therapy_for_high_grade_dysplasia_in_Barrett's_esophagus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542356503001289 DB - PRIME DP - Unbound Medicine ER -