Effect of multipolar electrocoagulation on EUS findings in Barrett's esophagus

Dose-dependent depth of tissue injury with carbon dioxide cryotherapy in porcine GI tract

“…As a reference, the average thickness of Barrett's mucosa in humans has been estimated to be approximately 1.5 mm, with a range in the literature from 0.8 to 3.3 mm. 13 Patients with Barrett's esophagus who were treated with CO 2 cryotherapy have had minimal to no side effects, such as chest pain, perforation, or esophageal stricture. 6,7 Hence, we can speculate that the depth of tissue injury from 8 cycles of 15 seconds of freeze followed by thaw might be associated with less injury in a clinical setting because of differences in a number of important factors influencing cryogen dose-response (ie, the thickness of the protective mucus layer, thickness of the epithelial layer, and/or extent of Barrett's esophagus treated).…”

A novel device for ablation of abnormal esophageal mucosa (with video)

“…As the application time is lengthened, progressively deeper sections of the esophageal wall are exposed to lower temperatures, resulting in deeper ablation. Histologic and endosonographic studies that measured the thickness of BE epithelium (0.4-0.6 mm), squamous epithelium (0.4-0.6 mm), and esophageal wall thickness (2.4 mm for normal esophagus, 3.1 mm nondysplastic BE, 3.4 mm BE with high-grade dysplasia) [18][19][20] serve as a guide to the optimal depth of ablation. The application time must be long enough to cause necrosis of up to 0.6 mm of BE epithelium (or perhaps slightly more in cases of high-grade dysplasia) while minimizing damage to the deeper portions of the esophageal wall.…”

Pilot Study on Light Dosimetry Variables for Photodynamic Therapy of Barrett's Esophagus with High-Grade Dysplasia

“…Further, our results agree with the previous results of Gill et al (26) who used EUS to measure esophageal thickness for 76 patients with BE and 53 normal controls. The mean (27) used EUS to measure esophageal thickness for Barrett's tissue both before and after multipolar electrocoagulation and found a small but significant decrease in thickness for successful treatments. EUS and OCT, both of which probe the submucosa, may be very useful in the future to monitor microvascular changes associated with optimal treatment and to supplement postablation mucosal biopsies for the detection of residual disease (4,28,29).…”