Durability of new squamous epithelium after endoscopic reversal of Barrett’s esophagus

Sharma, Prateek; Bhattacharyya, Achyut; Garewal, Harinder S.; Sampliner, Richard E.

doi:10.1016/s0016-5107(99)70218-x

Cited by 72 publications

(36 citation statements)

References 22 publications

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“…Studies followed the same patient population. 2 Studies followed the same patient population. 3 Studies followed the same patient population.…”

Section: Discussionmentioning

confidence: 99%

“…In 1999, Sharma et al [2] reported on 11 patients with BE who were followed by endoscopic surveillance after treatment with multipolar electrocoagulation and maintenance with high-dose PPI therapy (omeprazole; mean dose 49 mg/day). All patients had an initial complete response to treatment with no evidence of Barrett's epithelium macroscopically or at biopsy.…”

Section: Introductionmentioning

confidence: 99%

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Reduction of Acid Exposure and Regression of Barrett’s Esophagus

Sampliner

2000

Dig Dis

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The goals of treatment of Barrett’s esophagus (BE) include relieving reflux symptoms, healing inflammatory lesions, and preventing esophageal adenocarcinoma. Reduction of acid reflux is believed to prevent progression of BE. A critical question is whether or not regression of BE occurs in response to therapy with proton pump inhibitors. The natural history of BE is altered both by the use of medications (over-the-counter or prescribed) and by endoscopic surveillance with periodic biopsies. Regression occurs when the length and surface area of BE decreases, along with the emergence of islands of squamous epithelium in the BE segment. However, the extent of regression is difficult to assess because intestinal metaplasia may underlie the islands of squamous epithelial regrowth. Sampling by endoscopic biopsy is useful in ruling out progression of BE to dysplasia or adenocarcinoma; however, complete regression of the lesion cannot be definitively proven by this technique. To date, published clinical trials of proton pump inhibitor therapy in patients with BE provide evidence of increases in squamous islands in the BE segment, but do not provide convincing data in support of complete regression of BE. In a review of prospective studies of the treatment of BE with proton pump inhibitors (PPIs) (with or without surgery), only 3 of 123 patients had apparent complete reversal of BE. This article reviews the current understanding of regression in BE following treatment with PPIs.

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“…Studies followed the same patient population. 2 Studies followed the same patient population. 3 Studies followed the same patient population.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reduction of Acid Exposure and Regression of Barrett’s Esophagus

Sampliner

2000

Dig Dis

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“…This has been reported in 0-44 % of cases, and the long-term follow-up of successfully treated patients showed recurrence of SIM ranging from 0-68 % [149]. This is not specific for the type of ablative therapy, and a number of investigators using various modes of ablative therapy have reported this finding [150][151][152][153][154][155][156]. Residual SIM carries with it the potential to progress to dysplasia/EAC, but the magnitude of this risk is not well characterized [155,156].…”

Section: Ablation Therapy For Dysplasia and Eacmentioning

confidence: 91%

Carcinogenesis of Barrett’s esophagus: a review of the clinical literature

Watari

Oshima

Fukui

et al. 2013

Clin J Gastroenterol

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Barrett's esophagus (BE) is a premalignant condition of esophageal adenocarcinoma (EAC). Although the incidence of BE has risen rapidly in the West, it is rare in Asia despite a recent increase in the prevalence of gastroesophageal reflux disease. Controversies over the definition of BE are presented because most cases show shortsegment BE, especially ultra-short BE, in Asia. Here we review possible risk factors for the development of EAC, particularly possible roles of ethnicity, specialized intestinal metaplasia (SIM), BE length, and environmental factors, such as Helicobacter pylori infection and obesity. Additionally, we summarize recent studies on the effect of chemoprevention including proton pump inhibitors, nonsteroidal anti-inflammatory drugs or aspirin in order to reduce the risk of neoplastic progression in BE patients. Although substantial knowledge of risk factors of dysplasia/EAC in BE is shown, the risk for neoplastic development may be influenced by geographic variation, study population, the presence or absence of SIM or dysplasia at baseline, and the small number of BE patients investigated. Recently, the efficiency of surveillance for BE patients has been discussed from the standpoint of cost-effectiveness. It may be too difficult to draw conclusions because no randomized clinical trials of BE surveillance have been performed.

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“…Sampliner et al [24] observed only one case of stenosis out of 72 patients treated the same way. Sharma et al [25] and Sampliner et al [26] had no complications. However success rates were also lower, 81%, 78% and 73%, respectively.…”

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confidence: 85%

Histology assessment of bipolar coagulation and argon plasma coagulation on digestive tract

Garrido¹

2014

WJGE

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AIM:To analyze the effect of bipolar electrocoagulation and argon plasma coagulation on fresh specimens of gastrointestinal tract. METHODS:An experimental evaluation was performed at Hospital das Clinicas of the University of São Paulo, on 31 fresh surgical specimens using argon plasma coagulation and bipolar electrocoagulation at different time intervals. The depth of tissue damage was histopathologically analyzed by single senior pathologist unaware of the coagulation method and power setting applied. To analyze the results, the mucosa was divided in superficial mucosa (epithelial layer of the esophagus and superficial portion of the glandular layer of the stomach and colon) intermediate mucosa (until the lamina propria of the esophagus and until the bottom of the glandular layer of the stomach and colon) and muscularis mucosa. Necrosis involvement of the layers was compared in several combinations of power and time interval. RESULTS:Involvement of the intermediate mucosa of the stomach and of the muscularis mucosa of the three organs was more frequent when higher amounts of energy were used with argon plasma. In the esophagus and in the colon, injury of the intermediate mucosa was frequent, even when small amounts of energy were used. The use of bipolar electrocoagulation resulted in more frequent involvement of the intermediate mucosa and of the muscularis mucosa of the esophagus and of the colon when higher amounts of energy were used. In the stomach, these involvements were rare. The risk of injury of the muscularis propria was significant only in the colon when argon plasma coagulation was employed. CONCLUSION:Tissue damage after argon plasma coagulation is deeper than bipolar electrocoagulation. Both of them depend on the amount of energy used. Key words: Argon plasma coagulation; Electrocoagulation; Gastrointestinal endoscopy; Surgical procedures; Endoscopic gastrointestinal; Mucous membrane/injuries Core tip: The best way of applying heat to hollow digestive organs during thermal endoscopic therapy has not been clearly established so far. This study analyzes the histophathological effect of bipolar electrocoagulation and argon plasma coagulation on fresh surgical specimens of the digestive tract. Tissue damage after argon plasma coagulation is deeper than bipolar electrocoagulation. Both of them depends on the amount of energy used.

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Durability of new squamous epithelium after endoscopic reversal of Barrett’s esophagus

Cited by 72 publications

References 22 publications

Reduction of Acid Exposure and Regression of Barrett’s Esophagus

Reduction of Acid Exposure and Regression of Barrett’s Esophagus

Carcinogenesis of Barrett’s esophagus: a review of the clinical literature

Histology assessment of bipolar coagulation and argon plasma coagulation on digestive tract

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