Pesenti, ChristianRatone, Jean PhillipeGiovannini, MarcCaillol, FabricePoizat, FloraGodat, SebastienMarx, MariolaSchoepfer, AlainBories, ErwanAutret, AurélieRobert, MaximeBackground High-grade dysplasia (HGD) and intramucosal carcinoma (IMC) in Barrett’s esophagus (BE) are now well-established indications for endoscopic resection (ER). Radiofrequency ablation (RFA) can be combined with ER in case of flat or long-segment BE ablation. We report here our experience of complementary RFA after widespread ER of neoplastic BE in daily practice.
Method We retrospectively reviewed data of 89 patients, treated between 2006 and 2013 by ER alone (group 1) or by ER combined with RFA (group 2).
Results Fifty-five patients in group 1 (7F/48M, mean age 68 years) underwent widespread ER with eradication of residual non-dysplastic BE. Complete eradication of HGD/IMC and intestinal metaplasia (IM) was achieved in 32/32 (100%) and 48/55 (87.3%) patients, respectively. Thirty-four patients in group 2 (3F/31M, mean age 67 years) had a multimodal treatment strategy, with widespread ER followed by RFA. Mean Prague classification of BE in this group was significantly longer (C4.4M6.6 vs. C2.7M4.5, P<0.001). Complete eradication of HGD/IMC and non-dysplastic BE was confirmed in 26/27 (96.3%) and 20/34 (58.8%) patients, respectively. There was no significant difference between groups concerning adverse events (16.4% vs. 23.5%, P=0.58) or recurrence rate of HGD/IMC (9.1% vs. 14.7%, P=0.42). The mismatch rate between preoperative and final histological diagnosis was high in both groups, at 45.5% and 26.5%.
Conclusions A combination of ER and RFA can treat significantly longer neoplastic BE than ER alone, with the same efficiency and safety. Widespread ER, in contrast, is the only method of obtaining a reliable histological diagnosis.
Keywords Barrett’s esophagus, high-grade dysplasia, esophageal cancer, endoscopic resection, radiofrequency ablation
Ann Gastroenterol 2022; 35 (1): 34-41text/htmlapplication/pdfhttp://www.annalsgastro.gr/index.php/annalsgastro/article/view/5712engHellenic Society of GastroenterologyCopyright (c) 2022 Annals of Gastroenterology1792-74631108-7471Annals of Gastroenterology; Volume 35, No 1 (2022); 34Benefit of radiofrequency ablation after widespread endoscopic resection of neoplastic Barrett’s esophagus in daily practiceinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion2022-01-10Δημοσίευση σε περιοδικόPublication in journalΓαστροεντερολογίαGastroenterologyisi -Gastroenterology & Hepatology covers resources on the anatomy, physiology, biochemistry, and pathology of the digestive system. This category includes specific resources on the prognosis and treatment of digestive diseases; stomach ulcers; metabolic, genetic, infectious and chemically induced diseases of the liver; colitis; diseases of the pancreas and diseases of the rectum.Επιστημονικό άρθροScientific articleΕλληνική Γαστροεντερολογική ΕταιρίαGreek Aggregator OpenArchives.gr | National Documentation Centre (EKT)other