Outcomes of Radiofrequency Ablation for Dysplastic Barrett’s Esophagus: A Comprehensive Review
Barrett’s esophagus is a condition in which the normal squamous lining of the esophagus has been replaced by columnar epithelium containing intestinal metaplasia induced by recurrent mucosal injury related to gastroesophageal reflux disease. Barrett’s esophagus is a premalignant condition that can p...
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doaj-23b831d536e34d0f835ece2671ede4b42020-11-24T22:36:30ZengHindawi LimitedGastroenterology Research and Practice1687-61211687-630X2016-01-01201610.1155/2016/42495104249510Outcomes of Radiofrequency Ablation for Dysplastic Barrett’s Esophagus: A Comprehensive ReviewCarmelo Luigiano0Giuseppe Iabichino1Leonardo Henry Eusebi2Monica Arena3Pierluigi Consolo4Carmela Morace5Enrico Opocher6Benedetto Mangiavillano7Unit of Digestive Endoscopy, San Paolo Hospital, Via A. Di Rudiní, No. 8, 20142 Milano, ItalyUnit of Digestive Endoscopy, San Paolo Hospital, Via A. Di Rudiní, No. 8, 20142 Milano, ItalyHPB Endoscopy, Royal Free Hospital, London, UKUnit of Digestive Endoscopy, San Paolo Hospital, Via A. Di Rudiní, No. 8, 20142 Milano, ItalyDepartment of Medicine and Pharmacology, University of Messina, Hospital “G. Martino”, Via Consolare Valeria, 98124 Messina, ItalyDepartment of Medicine and Pharmacology, University of Messina, Hospital “G. Martino”, Via Consolare Valeria, 98124 Messina, ItalyDepartment of Surgery, Unit of Hepatobilyopancreatic and Digestive Surgery, San Paolo Hospital, University of Milan, Via A. Di Rudiní, No. 8, 20142 Milano, ItalyUnit of Digestive Endoscopy, Istituto Clinico Humanitas Mater Domini, Via Gerenzano 2, 21053 Castellanza, ItalyBarrett’s esophagus is a condition in which the normal squamous lining of the esophagus has been replaced by columnar epithelium containing intestinal metaplasia induced by recurrent mucosal injury related to gastroesophageal reflux disease. Barrett’s esophagus is a premalignant condition that can progress through a dysplasia-carcinoma sequence to esophageal adenocarcinoma. Multiple endoscopic ablative techniques have been developed with the goal of eradicating Barrett’s esophagus and preventing neoplastic progression to esophageal adenocarcinoma. For patients with high-grade dysplasia or intramucosal neoplasia, radiofrequency ablation with or without endoscopic resection for visible lesions is currently the most effective and safe treatment available. Recent data demonstrate that, in patients with Barrett’s esophagus and low-grade dysplasia confirmed by a second pathologist, ablative therapy results in a statistically significant reduction in progression to high-grade dysplasia and esophageal adenocarcinoma. Treatment of dysplastic Barrett’s esophagus with radiofrequency ablation results in complete eradication of both dysplasia and of intestinal metaplasia in a high proportion of patients with a low incidence of adverse events. A high proportion of treated patients maintain the neosquamous epithelium after successful treatment without recurrence of intestinal metaplasia. Following successful endoscopic treatment, endoscopic surveillance should be continued to detect any recurrent intestinal metaplasia and/or dysplasia. This paper reviews all relevant publications on the endoscopic management of Barrett’s esophagus using radiofrequency ablation.http://dx.doi.org/10.1155/2016/4249510 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Carmelo Luigiano Giuseppe Iabichino Leonardo Henry Eusebi Monica Arena Pierluigi Consolo Carmela Morace Enrico Opocher Benedetto Mangiavillano |
spellingShingle |
Carmelo Luigiano Giuseppe Iabichino Leonardo Henry Eusebi Monica Arena Pierluigi Consolo Carmela Morace Enrico Opocher Benedetto Mangiavillano Outcomes of Radiofrequency Ablation for Dysplastic Barrett’s Esophagus: A Comprehensive Review Gastroenterology Research and Practice |
author_facet |
Carmelo Luigiano Giuseppe Iabichino Leonardo Henry Eusebi Monica Arena Pierluigi Consolo Carmela Morace Enrico Opocher Benedetto Mangiavillano |
author_sort |
Carmelo Luigiano |
title |
Outcomes of Radiofrequency Ablation for Dysplastic Barrett’s Esophagus: A Comprehensive Review |
title_short |
Outcomes of Radiofrequency Ablation for Dysplastic Barrett’s Esophagus: A Comprehensive Review |
title_full |
Outcomes of Radiofrequency Ablation for Dysplastic Barrett’s Esophagus: A Comprehensive Review |
title_fullStr |
Outcomes of Radiofrequency Ablation for Dysplastic Barrett’s Esophagus: A Comprehensive Review |
title_full_unstemmed |
Outcomes of Radiofrequency Ablation for Dysplastic Barrett’s Esophagus: A Comprehensive Review |
title_sort |
outcomes of radiofrequency ablation for dysplastic barrett’s esophagus: a comprehensive review |
publisher |
Hindawi Limited |
series |
Gastroenterology Research and Practice |
issn |
1687-6121 1687-630X |
publishDate |
2016-01-01 |
description |
Barrett’s esophagus is a condition in which the normal squamous lining of the esophagus has been replaced by columnar epithelium containing intestinal metaplasia induced by recurrent mucosal injury related to gastroesophageal reflux disease. Barrett’s esophagus is a premalignant condition that can progress through a dysplasia-carcinoma sequence to esophageal adenocarcinoma. Multiple endoscopic ablative techniques have been developed with the goal of eradicating Barrett’s esophagus and preventing neoplastic progression to esophageal adenocarcinoma. For patients with high-grade dysplasia or intramucosal neoplasia, radiofrequency ablation with or without endoscopic resection for visible lesions is currently the most effective and safe treatment available. Recent data demonstrate that, in patients with Barrett’s esophagus and low-grade dysplasia confirmed by a second pathologist, ablative therapy results in a statistically significant reduction in progression to high-grade dysplasia and esophageal adenocarcinoma. Treatment of dysplastic Barrett’s esophagus with radiofrequency ablation results in complete eradication of both dysplasia and of intestinal metaplasia in a high proportion of patients with a low incidence of adverse events. A high proportion of treated patients maintain the neosquamous epithelium after successful treatment without recurrence of intestinal metaplasia. Following successful endoscopic treatment, endoscopic surveillance should be continued to detect any recurrent intestinal metaplasia and/or dysplasia. This paper reviews all relevant publications on the endoscopic management of Barrett’s esophagus using radiofrequency ablation. |
url |
http://dx.doi.org/10.1155/2016/4249510 |
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