Abstract | BACKGROUND AND STUDY AIMS: METHODS: Patients diagnosed with Barrett's esophagus underwent monthly stepwise cryoablation with pressurized CO (2) gas, with follow-up esophageal biopsies until complete histological reversal was achieved. Responses were analyzed with an intention-to-treat analysis according to complete response for intestinal metaplasia (CR-IM), which was defined as the elimination of all intestinal metaplasia including specialized intestinal metaplasia (SIM), subsquamous SIM, and dysplasia with intestinal metaplasia in the biopsies under narrow-band imaging (NBI). RESULTS: In total, 22 patients were enrolled, 20 of whom completed the treatment. Two patients declined further ablation after the first cryotherapy session. A total of 44 sessions were performed; a median of 2 sessions per patient (range 1 - 3 sessions) were needed to complete the ablation of Barrett's esophagus. No severe complications occurred. Follow-up endoscopies were performed in 20 patients (90.9 %). Two patients (9.1 %) were lost to follow-up. Median follow-up was 10 months (range 6 - 18 months). After cryotherapy, 20 patients (90.9 %) reached CR-IM of Barrett's esophagus. Patients underwent a median number of 3 follow-up endoscopies (range 2 - 4) with biopsies. At 6 months, recurrence was evident in three patients (13.6 % of the overall population, 15.0 % of the CR-IM population). One of the three patients developed intestinal metaplasia but no dysplastic change and the other two developed subsquamous SIM. CONCLUSIONS:
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Authors | H B Xue, H H Tan, W Z Liu, X Y Chen, N Feng, Y J Gao, Y Song, Y J Zhao, Z Z Ge |
Journal | Endoscopy
(Endoscopy)
Vol. 43
Issue 5
Pg. 379-85
(May 2011)
ISSN: 1438-8812 [Electronic] Germany |
PMID | 21437849
(Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © Georg Thieme Verlag KG Stuttgart · New York. |
Chemical References |
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Topics |
- Aged
- Barrett Esophagus
(pathology, therapy)
- Biopsy
- Carbon Dioxide
- Cryotherapy
(methods)
- Epithelium
(pathology)
- Esophagus
(pathology)
- Female
- Follow-Up Studies
- Gastroscopy
- Humans
- Male
- Middle Aged
- Pilot Projects
- Prospective Studies
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