Document Detail


High recurrence rate of Barrett's epithelium during long-term follow-up after argon plasma coagulation.
MedLine Citation:
PMID:  17190758     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Several studies have shown that argon plasma coagulation (APC) combined with proton-pump inhibitor (PPI) therapy is a suitable procedure to eradicate Barrett's epithelium for a short-term follow-up. The real impact of this kind of management with respect to cancer risk and durability of squamous regeneration remains unclear. We present the follow-up data for up to 51 months after eradication of Barrett's mucosa. MATERIAL AND METHODS: In 1998-2001, 25 patients with Barrett's esophagus were included in a prospective study. After baseline documentation, Barrett's epithelium was treated with repeated APC until complete squamous restoration was reached. Thereafter, all patients were continuously treated with high-dose PPIs. RESULTS: Each patient underwent a median of four APC sessions. Twenty-one (84%) of the patients had complete squamous regeneration at the end of treatment. During a follow-up of up to 51 months, Barrett's epithelium was found to have recurred in 14/21 (66%) patients. Including the patients with initially incomplete squamous restoration, a long-lasting and complete effect was achieved in only 7 patients (28%) after a mean follow-up period of 30 months. CONCLUSIONS: So far, it is still not proven whether coagulation-induced squamous regeneration reduces the risk of Barrett's carcinoma. Furthermore, the high relapse rate, the procedure-related risk, and the high costs incurred preclude the routine use of APC for the treatment of non-dysplastic Barrett's esophagus. The different recurrence rates between published studies may be due to technical differences and PPI schedule. We suggest that optimal conditions for the procedure must be defined before further studies are undertaken.
Authors:
Hubert Mörk; Oliver Al-Taie; Frauke Berlin; Michael R Kraus; Michael Scheurlen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  42     ISSN:  0036-5521     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2006-12-27     Completed Date:  2007-03-22     Revised Date:  2008-05-22    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  23-7     Citation Subset:  IM    
Affiliation:
Kreiskrankenkaus Nagold, Nagold, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Barrett Esophagus / surgery*
Female
Follow-Up Studies
Humans
Laser Coagulation*
Male
Middle Aged
Recurrence
Comments/Corrections
Comment In:
Scand J Gastroenterol. 2008;43(2):251; author reply 252   [PMID:  17934978 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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