Prevention of the neoplastic progression of Barrett's oesophagus by endoscopic argon beam plasma ablation

被引:48
作者
Morris, CD [1 ]
Byrne, JP [1 ]
Armstrong, GRA [1 ]
Attwood, SEA [1 ]
机构
[1] Hope Hosp, Dept Upper Gastrointestinal Surg, Manchester M6 8HD, Lancs, England
关键词
D O I
10.1046/j.0007-1323.2001.01926.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Patients with Barrett's oesophagus have a risk of approximately 1 per 100 patient-years for the development of oesophageal adenocarcinoma. Endoscopic ablation of Barrett's oesophagus has been shown to lead to the regrowth of a 'neo' squamous epithelium if gastro-oesophageal reflux is controlled, but the incidence of subsequent tumour formation is unknown. Methods: The follow-up of 55 patients who underwent endoscopic ablation of Barrett's oesophagus by argon beam plasma coagulation (ABPC) is reported. Of the 55 patients, nine had low-grade dysplasia, nine had high-grade dysplasia and the remainder had non-dysplastic Barrett's metaplasia. Twelve patients had reflux control by antireflux surgery and the remainder received proton pump inhibitor therapy. Barrett's metaplasia was ablated by ABPC to within 2 cm of the gastro-oesophageal junction. Results: To date, one patient has died and one patient was unable to complete treatment. The remaining patients were followed by regular endoscopic surveillance for a mean of 38.5 months to give a total follow-up of 173.5 patient-years. No malignancy has developed in any patient during follow-up. Conclusion: The absence of malignant complications in this study of prophylactic ablation of long-segment Barrett's oesophagus strengthens the argument for endoscopic ablation in the prevention of oesophageal adenocarcinoma.
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页码:1357 / 1362
页数:6
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