Endoscopic ablation of Barrett's esophagus using argon plasma coagulation (APC) following surgical laparoscopic fundoplication

Abstract

The success rate of APC ablation following laparoscopic antireflux surgery in our series may be as high as 91%. Nevertheless, small islands of intestinal metaplasia under the new squamous epithelium may persist in some patients. In these circumstances, the authors recommend that endoscopic ablation of BE should be confined to controlled clinical trials.

Randomized Trial of Argon Plasma Coagulation Versus Endoscopic Surveillance for Barrett Esophagus After Antireflux Surgery: Late Results

“…In the published postsurgical APC ablation studies, the length of follow-up has been relatively short, with the mean duration of follow-up being 17 18 and 31.9 months. 19 Successful initial neosquamous re-epithelialization was achieved in more than 90% of patients in these studies, and similar outcomes have been reported for ablation using bipolar electrocoagulation 20 and endoscopic laser 21 in patients who had undergone a previous fundoplication.…”

Predictors for squamous re‐epithelialization of Barrett’s esophagus after endoscopic biopsy

“…The results of the present study suggest that relapse can be found more frequently in patients with the intestinal predominant mucin phenotype. However, several investigators have reported that relapse of Barrett’s mucosa derives from remnant Barrett’s epithelial cells underneath the newly developed squamous epithelium after endoscopic mucosal ablation 55–57 . In future studies, it will be necessary to elucidate the relationship between relapse of Barrett’s esophagus and the mucin phenotype of remaining Barrett’s mucosa in the subepithelial layer.…”

Seguimiento Endoscópico E Histológico Post Ablación Con Argón Plasma Del Esófago De Barrett Extenso en Pacientes Sometidos a Tratamiento Quirúrgico Previo

“…De allí surge la posibilidad de someter a estos pacientes a ablación con argón plasma por vía endoscópica para disminuir este riesgo de desarrollar un adenocarcinoma [1][2][3][4][5] . Recientemente se ha descrito la restauración parcial de la mucosa escamosa después de la ablación de EB con técnicas endoscópicas 6,7 .…”