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

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Ahmed Madisch - , University Hospital Carl Gustav Carus Dresden, Department of internal Medicine I (Author)
  • Stephan Miehlke - , University Hospital Carl Gustav Carus Dresden, Department of internal Medicine I (Author)
  • Ekkehard Bayerdoerffer - , University Hospital Gießen and Marburg (Author)
  • Birgit Wiedemann - , Institute for Medical Informatics and Biometry (Author)
  • David Antos - , Ludwig Maximilian University of Munich (Author)
  • Anke Sievert - , Privatpraxis in Bremen (Author)
  • Michael Vieth - , Otto von Guericke University Magdeburg (Author)
  • Manfred Stolte - , Klinikum Bayreuth GmbH (Author)
  • Heinrich Schulz - , Privatpraxis in Bremen (Author)

Abstract

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 histologically 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).

Details

Original languageEnglish
Pages (from-to)1182-1186
Number of pages5
JournalWorld Journal of Gastroenterology
Volume11
Issue number8
Publication statusPublished - 28 Feb 2005
Peer-reviewedYes

External IDs

PubMed 15754401

Keywords

ASJC Scopus subject areas

Keywords

  • Argon plasma coagulation, Barrett's esophagus, Esophageal adenocarcinoma