scholarly journals Endoscopic Resection and Radiofrequency Ablation for Early Esophageal Neoplasia

2016 ◽  
Vol 34 (5) ◽  
pp. 469-475 ◽  
Author(s):  
Kamar Belghazi ◽  
Jacques Bergman ◽  
Roos E. Pouw
Keyword(s):  
Radiofrequency Ablation ◽  
Endoscopic Resection ◽  
Additional Treatment ◽  
Optimal Decision ◽  
Histological Evaluation ◽  
Endoscopic Management ◽  
Esophageal Neoplasia ◽  
Neoplastic Lesions ◽  
Barrett’S Mucosa ◽  
Barrett's Mucosa

Background: In the last few decades, endoscopic treatment of early neoplastic lesions in the esophagus has established itself as a valid and less invasive alternative to surgical resection. Endoscopic resection (ER) is the cornerstone of endoscopic therapy. Next to the curative potential of ER, by removing neoplastic lesions, ER may also serve as a diagnostic tool. The relatively large tissue specimens obtained with ER enable accurate histological staging of a lesion, allowing for optimal decision-making for further patient management. ER was pioneered in Japan, mainly for the resection of gastric lesions and squamous esophageal neoplasia, and also Western countries have been increasingly implementing ER in the treatment of early gastroesophageal neoplasia, mostly associated with Barrett's esophagus (BE). In BE, however, there is still a risk of metachronous lesions in the remainder of the Barrett's after focal ER. Additional treatment of all Barrett's mucosa is therefore advised. Currently, the most effective method for this is by using radiofrequency ablation (RFA). This review will provide an overview of indications for ER and RFA. Key Messages and Conclusions: Endoscopic management of early esophageal neoplasia is a safe and valid alternative to surgery and is nowadays the treatment of choice. ER is the mainstay of endoscopic management of early esophageal neoplasia since it allows for removal of neoplastic lesions and provides a large tissue specimen for histological evaluation. In case of early neoplasia in BE, focal ER should be complemented by eradication of the remaining Barrett's mucosa. RFA has proven to be a safe and effective modality to achieve complete eradication of Barrett's mucosa.

Endoscopic Management of Barrett’s Esophagus and Early Esophageal Neoplasia

2019 ◽  
Author(s):  
Amanpal Singh ◽  
Andrew J Bain ◽  
Ramon Rivera
Keyword(s):  
Esophageal Cancer ◽  
Radiofrequency Ablation ◽  
High Risk ◽  
Acid Reflux ◽  
Barrett Esophagus ◽  
Endoscopic Management ◽  
Early Esophageal Cancer ◽  
Esophageal Neoplasia ◽  
Risk Patients ◽  
Ablative Techniques

Gastroesophageal reflux disease is common in North America, affecting around 25% of the population. A small fraction of these patients develop Barrett esophagus and thus are at a risk of developing esophageal cancer. The progression of Barrett esophagus to esophageal cancer can be prevented with timely examinations and, when necessary, by performing treatments to eradicate it. This review describes the use of endoscopy techniques to diagnose and classify Barrett esophagus among high-risk patients and the use of ablative techniques in patients with dysplasia. The review also describes endoscopic resection techniques for early esophageal cancer, which can provide staging information as well as can be therapeutic in selected cases. This review contains 8 figures and 49 references. Key Words: acid reflux, Barrett esophagus, cryoablation, endoscopic mucosal resection, endoscopic submucosal dissection, esophageal cancer, esophagus ablation, GERD, radiofrequency ablation

Endoscopic Management of Barrett’s Esophagus and Early Esophageal Neoplasia

2019 ◽  
Author(s):  
Amanpal Singh ◽  
Andrew J Bain ◽  
Ramon Rivera
Keyword(s):  
Esophageal Cancer ◽  
Radiofrequency Ablation ◽  
High Risk ◽  
Acid Reflux ◽  
Barrett Esophagus ◽  
Endoscopic Management ◽  
Early Esophageal Cancer ◽  
Esophageal Neoplasia ◽  
Risk Patients ◽  
Ablative Techniques

Gastroesophageal reflux disease is common in North America, affecting around 25% of the population. A small fraction of these patients develop Barrett esophagus and thus are at a risk of developing esophageal cancer. The progression of Barrett esophagus to esophageal cancer can be prevented with timely examinations and, when necessary, by performing treatments to eradicate it. This review describes the use of endoscopy techniques to diagnose and classify Barrett esophagus among high-risk patients and the use of ablative techniques in patients with dysplasia. The review also describes endoscopic resection techniques for early esophageal cancer, which can provide staging information as well as can be therapeutic in selected cases. This review contains 8 figures and 49 references. Key Words: acid reflux, Barrett esophagus, cryoablation, endoscopic mucosal resection, endoscopic submucosal dissection, esophageal cancer, esophagus ablation, GERD, radiofrequency ablation

A simplified regimen for focal radiofrequency ablation of Barrett's mucosa: a randomized multicenter trial comparing two ablation regimens

2013 ◽  
Vol 78 (1) ◽  
pp. 30-38 ◽  
Author(s):  
Frederike G.I. van Vilsteren ◽  
K. Nadine Phoa ◽  
Lorenza Alvarez Herrero ◽  
Roos E. Pouw ◽  
Carine M.T. Sondermeijer ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Multicenter Trial ◽  
Barrett’S Mucosa ◽  
Barrett's Mucosa

732 A Multicenter Randomized Trial Comparing Two Ablation Regimens for Focal Radiofrequency Ablation of Barrett's Mucosa Using the HALO90 System

2012 ◽  
Vol 142 (5) ◽  
pp. S-1038 ◽  
Author(s):  
Frederike G. van Vilsteren ◽  
Lorenza Alvarez Herrero ◽  
Roos E. Pouw ◽  
Kai Yi N. Phoa ◽  
Carine Sondermeijer ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Randomized Trial ◽  
Multicenter Randomized Trial ◽  
Barrett’S Mucosa ◽  
Barrett's Mucosa

Endoscopic features of buried Barrett’s mucosa

2020 ◽  
Author(s):  
Linda S. Yang ◽  
Bronte A. Holt ◽  
Richard Williams ◽  
Richard Norris ◽  
Edward Tsoi ◽  
...  
Keyword(s):  
Barrett’S Mucosa ◽  
Barrett's Mucosa

scholarly journals Endoscopic management of superficial nonampullary duodenal tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Endoscopy ◽  
2021 ◽  
Author(s):  
Geoffroy Vanbiervliet ◽  
Alan Moss ◽  
Marianna Arvanitakis ◽  
Urban Arnelo ◽  
Torsten Beyna ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
En Bloc Resection ◽  
Endoscopic Management ◽  
Duodenal Adenoma ◽  
En Bloc ◽  
Strong Recommendation ◽  
Delayed Bleeding ◽  
Duodenal Adenomas ◽  
Moderate Quality ◽  
Quality Evidence

Main recommendations 1 ESGE recommends that all duodenal adenomas should be considered for endoscopic resection as progression to invasive carcinoma is highly likely.Strong recommendation, low quality evidence. 2 ESGE recommends performance of a colonoscopy, if that has not yet been done, in cases of duodenal adenoma.Strong recommendation, low quality evidence. 3 ESGE recommends the use of the cap-assisted method when the location of the minor and/or major papilla and their relationship to a duodenal adenoma is not clearly established during forward-viewing endoscopy.Strong recommendation, moderate quality evidence. 4 ESGE recommends the routine use of a side-viewing endoscope when a laterally spreading adenoma with extension to the minor and/or major papilla is suspected.Strong recommendation, low quality evidence. 5 ESGE suggests cold snare polypectomy for small (< 6 mm in size) nonmalignant duodenal adenomas.Weak recommendation, low quality evidence. 6 ESGE recommends endoscopic mucosal resection (EMR) as the first-line endoscopic resection technique for nonmalignant large nonampullary duodenal adenomas.Strong recommendation, moderate quality evidence. 7 ESGE recommends that endoscopic submucosal dissection (ESD) for duodenal adenomas is an effective resection technique only in expert hands.Strong recommendation, low quality evidence. 8 ESGE recommends using techniques that minimize adverse events such as immediate or delayed bleeding or perforation. These may include piecemeal resection, defect closure techniques, noncontact hemostasis, and other emerging techniques, and these should be considered on a case-by-case basis.Strong recommendation, low quality evidence. 9 ESGE recommends endoscopic surveillance 3 months after the index treatment. In cases of no recurrence, a further follow-up endoscopy should be done 1 year later. Thereafter, surveillance intervals should be adapted to the lesion site, en bloc resection status, and initial histological result. Strong recommendation, low quality evidence.

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