Prevention of the neoplastic progression of Barrett's oesophagus by endoscopic argon beam plasma ablation
Prevention of the neoplastic progression of Barrett's oesophagus by endoscopic argon beam plasma ablation
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DOI：
10.1046/j.0007-1323.2001.01926.x
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发表时间：
2001-10-01
影响因子：
9.6
通讯作者：
Attwood, SEA
中科院分区：
文献类型：
--
作者：
Morris, CD;Byrne, JP;Attwood, SEA
背景：Barrett‘s食管病患者发生食管腺癌的风险约为每100人年1例。经胃镜下切除Barrett‘s食管者，如果胃-食道反流得到控制，可导致’新的‘鳞状上皮再生，但后续肿瘤形成的发生率尚不清楚。方法：报道55例经鼻内窥镜下经氩离子凝固术(ABPC)切除Barrett’s食管者。55例患者中，9例为低度异型增生，9例为高度异型增生，其余为非异型巴雷特化生。12例患者通过抗返流手术控制反流，其余患者接受质子泵抑制剂治疗。结果：目前已有1例患者死亡，1例患者无法完成治疗。其余的患者接受了平均38.5月的定期内窥镜监测，总的随访期为173.5人年。结论：本研究中无恶性并发症发生，预防性切除长节段Barrett‘s食道的研究加强了内窥镜下切除预防食管腺癌的论据。
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.