Detection of Intestinal Metaplasia After Successful Eradication of Barrett’s Esophagus with Radiofrequency Ablation
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Benjamin J. Vaccaro Susana Gonzalez John M. Poneros Peter D. Stevens Kristina M. Capiak Charles J. Lightdale Julian A. Abrams
- چاپ و سال / کشور: 2011
Description
Background Radiofrequency ablation (RFA) is an effective means of eradicating Barrett’s esophagus (BE), both with and without associated dysplasia. Several studies have documented high initial success rates with RFA. However, there is limited data on IM detection rates after eradication. Aims To determine the rate of detection of intestinal metaplasia (IM) after successful eradication of Barrett’s esophagus. Methods BE patients with and without dysplasia who had undergone RFA were retrospectively identified. Only those who had complete eradication as documented on the initial post-ablation endoscopy, and had minimum two surveillance endoscopies, were included in the analyses. Clinical, demographic, and endoscopic data were collected. Cumulative incidence of IM detection was calculated by the Kaplan–Meier method. Results Forty-seven patients underwent RFA and had complete eradication of Barrett’s epithelium. The majority of patients were male (76.6%), and the mean age was 64.2 years. The cumulative incidence of newly detected IM at 1 year was 25.9% (95% CI 15.1–42.1%). Dysplasia was detected at the time of recurrence in four patients, and all cases were detected at the GE junction in the absence of visible BE. Patients with recurrent IM had longer baseline segments of BE (median, 4 cm vs. 2 cm, p = 0.03). Conclusions The rate of detection of new IM is high in patients who have undergone successful eradication of BE by RFA. Additionally, dysplasia can recur at the GE junction in the absence of visible BE. Future studies are warranted to identify those patients at increased risk for the development of recurrent intestinal metaplasia
Dig Dis Sci (2011) 56:1996–2000 DOI 10.1007/s10620-011-1680-4 Received: 27 October 2010 / Accepted: 11 March 2011 / Published online: 6 April 2011
