Endoscopic management of Barrett's esophagus

ABSTRACT

Barrett's esophagus [BE] has a malignant potential. Neither acid suppression nor anti reflux surgery produce consistent or complete regression of metaplastic epithelium. Is to determine the efficacy of endoscopic therapy in management of BE. This study was carried out on 25 patients [18 males and 7 Females], with BE that was confirmed by biopsy and histopatholoay. According to the histopathological examination, 24 patients had BE with no dysplasia or low-grade dysplasia [LGD]. Ablation of Barrett's mucosa in those patients was done using argon plasma coagulation [APC]. Also, one patient who had [BE] with high-grade dysplasia [HGD]. Ablation of Barrett's mucosa in this patient was done using EMR [endoscopic mucosal resection]. As regards APC, successful ablation was achieved with complete clearance of BE in [71%] of patients and during the follow-up period only [12%] of those patients revealed buried BE glands on histopathological examinations. Complications as self-limiting chest discomfort [25%], odynophagia [20%], and temporary dysphagia [4%] were observed during the follow-up period. As regards EMR, it was performed only in one patient who had BE with HGD. The procedure was performed using lift and cut technique. EMR in this study was successful with no complications. Argon plasma coagulation [APC] ablative therapy for [BE] proved to be safe and well tolerated, with only minor self-limiting side effects. -Endoscopic mucosal resection [EMR], in ablation of BE with HGD, is an emerging and promising technique in treatment of 4splastic and malignant lesions within BE