Diode laser treatment of Barrett’s esophagus: long-term results
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Lino Polese & Imerio Angriman & Marco Scarpa & Duilio Pagano & Paola Parente & Francesca Erroi & Mauro Frego & Davide F. D’Amico & Lorenzo Norberto
- چاپ و سال / کشور: 2011
Description
Different ablation techniques have been utilized in the treatment of Barrettپfs esophagus (BE) to reduce the risk of degeneration. Treatment complications, risk of recurrence, and buried intestinal metaplasia (IM) are all major concerns. The effect of diode laser treatment on BE, studied in a group of patients over a long-term period, is presented here. All patients with histology of IM or low-grade dysplasia (LGD) treated with diode laser therapy for BE and followed for at least 24 months were included in the study. Treatment sessions were carried out every 3 months and bioptic follow-up examinations were done yearly. Patients without antireflux surgery received proton pump inhibitors. A total of 20 patients with IM, four of them with LGD, were treated with 161 laser sessions (in mean eight per patient) without complications. Complete, sustained endoscopic and histologic remission was obtained in 13 patients (11/12 with BE . 3 cm and 2/8 with BE >3 cm, p<0.01) and a mean of 83پ}27% of the metaplasic tissue was removed in all the patients. All four cases of LGD healed to squamous tissue. No buried metaplasia, recurrences, or disease progressions were reported after a mean follow-up of 6 years and 2 months. Diode laser ablation is a safe and effective method in most cases of short BE, while it is less effective in the long form, requiring a large number of sessions. Long-term results show that the risk of recurrence and of buried intestinal metaplasia underneath neosquamous epithelium is negligible.
Lasers Med Sci (2011) 26:223–228 DOI 10.1007/s10103-010-0836-3 Received: 24 August 2009 / Accepted: 24 August 2010 / Published online: 7 September 2010
