Hot avulsion may be effective as salvage treatment for focal Barrett's esophagus remaining after endoscopic therapy for dysplasia or early cancer: a preliminary study.
Endoscopy
; 50(1): 8-13, 2018 01.
Article
em En
| MEDLINE
| ID: mdl-29065436
ABSTRACT
BACKGROUND AND STUDY AIM:
Both endoscopic mucosal resection (EMR) and radiofrequency ablation (RFA) are used to treat Barrett's esophagus (BE) complicated by dysplasia and intramucosal cancer. However, focal areas of BE can remain after otherwise successful application of these techniques. We report the results of hot avulsion using a hot biopsy forceps to resect these residual focal areas. PATIENTS ANDMETHODS:
This was a retrospective study from a prospective database in a tertiary reference center from August 2013 to May 2015.âAll included patients had undergone hot avulsion for eradication of residual focal areas of BE that wereâ≤â1âcm and not suspicious for dysplasia, following at least one previous endoscopic treatment for dysplasia or intramucosal cancer.RESULTS:
35 patients harboring 124 residual areas of 1â-â7âmm were treated with hot avulsion. After a mean follow-up of 17.4 months, all patients achieved complete eradication of residual focal BE. One of the patients required a second hot avulsion treatment. Hot avulsion provided samples in all cases but limited the assessment of dysplasia (cautery artifact) in 20.2â% of them. The only complication was bleeding in two patients, which was easily stopped by soft coagulation.CONCLUSIONS:
Hot avulsion appears to be effective and safe in removing focal BEâ≤â1âcm at its greatest length remaining after endoscopic treatment for dysplasia or early cancer. Further studies are required before this technique can be considered the standard of care.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Esôfago de Barrett
/
Neoplasias Esofágicas
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Terapia de Salvação
Tipo de estudo:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Aged
/
Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Canadá