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Long-term follow-up after complete ablation of Barrett's esophagus with argon plasma coagulation

World Journal of Gastroenterology 2005年第8期11卷 1182-1186页

作者： Ahmed Madisch Stephan Miehike Ekkehard Bayerdoerffer birgit wiedemann David Antos Anke Sievert Michael Vieth Manfred Stolte Heinrich Schulz Medical Department Ⅰ Department of Hematology and Oncology Institute of Medical Statistics and Biometry Clinic for Pediatric Diseases Gastroenterologist in private practice Institute of Pathology

AIM: To report the long-term outcome of patients after complete ablation of non-neoplastic Barrett's esophagus (BE) with respect to BE relapse and development of intraepithelial neoplasia or esophageal adenocarcinoma. METHODS: In 70 patients with historically proven non neoplastic BE, complete BE ablation was achieved by argon plasma coagulation (APC) and high-dose proton pump inhibitor therapy (120 mg omeprazole daily). Sixty-six patients (94.4%) underwent further surveillance endoscopy. At each surveillance endoscopy four-quadrant biopsies were taken from the neo-squamous epithelium at 2 cm intervals depending on the pre-treatment length of BE mucosa beginning at the neo-Z-line, and from any endoscopically suspicious lesion. RESULTS: The median follow-up of 66 patients was 51 mo (range 9-85 mo) giving a total of 280.5 patient years. A mean of 6 biopsies were taken during surveillance endoscopies. In 13 patients (19.7%) tongues or islands suspicious for BE were found during endoscopy. In 8 of these patients (12.1%) non-neoplastic BE relapse was confirmed histologically giving a histological relapse rate of 3% per year. In none of the patients, intraepithelial neoplasia nor an esophageal adenocarcinoma was detected. Logistic regression analysis identified endoscopic detection of islands or tongues as the only positive predictor of BE relapse (P= 0.0004). CONCLUSION: The long-term relapse rate of non neoplastic BE following complete ablation with high-power APC is low (3% per year).

关键词： Barrett's esophagus Argon plasma coagulation Esophageal adenocarcinoma

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