Management of Barrett Esophagus Following Radiofrequency Ablation.
Radiofrequency ablation (RFA) effectively treats dysplastic Barrett esophagus (BE), reduces the risk of esophageal adenocarcinoma (EAC), and infrequently produces complications. Complications of RFA include chest discomfort, esophageal stricturing, and bleeding. However, chest discomfort is usually...
| Published in: | Gastroenterology & Hepatology Vol. 15; no. 7; pp. 377 - 387 |
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| Main Authors: | , |
| Format: | review tables/charts Journal Article |
| Published: |
Gastro-Hep Communications, Inc
Jul2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=137681885&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 137681885 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15547914 6N5B jtl: Gastroenterology & Hepatology issn: 15547914 maglogo: N pubinfo: dt: Jul2019 vid: 15 iid: 7 pid: 72163 pub: Gastro-Hep Communications, Inc place: New York, New York artinfo: ui: 137681885 137681885 137681885 137681885 ppf: 377 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Management of Barrett Esophagus Following Radiofrequency Ablation. aug: au: Reed, Craig C. Shaheen, Nicholas J. affil: Clinical instructor of medicine in the Division of Gastroenterology and Hepatology in the Department of Medicine at the University of North Carolina School of Medicine in Chapel Hill, North Carolina sug: subj: Barrett Esophagus Surgery Catheter Ablation Adverse Effects Barrett Esophagus Therapy Recurrence Therapy Metaplasia Surgery Esophageal Neoplasms Prevention and Control Disease Surveillance Chemoprevention Barrett Esophagus Diagnosis Recurrence Risk Factors Risk Assessment Methods ab: Radiofrequency ablation (RFA) effectively treats dysplastic Barrett esophagus (BE), reduces the risk of esophageal adenocarcinoma (EAC), and infrequently produces complications. Complications of RFA include chest discomfort, esophageal stricturing, and bleeding. However, chest discomfort is usually transient and mild, strictures are generally amenable to dilation, and clinically significant bleeding is rare. Following RFA, intestinal metaplasia recurs at a rate of approximately 10% per patient year of follow-up time. Postablation dysplastic BE and EAC are rare. Moreover, recurrent disease is generally responsive to further endoscopic therapy and is associated with a benign clinical course. Although RFA is effective at producing low rates of postablation EAC and dysplastic recurrence, data suggest that current consensus guidelines for postablation surveillance are overly aggressive, as they mirror those for treatment-naive cohorts. Future guidelines may attenuate surveillance intervals, reducing the burden of endoscopic surveillance while providing for adequate detection of recurrent disease. Additional studies are needed to determine the length of time patients should ultimately remain in surveillance programs. Uncertainty exists regarding the appropriate application of chemopreventive measures (including proton pump inhibitors, aspirin, and statins) and novel imaging and sampling modalities (such as optical coherence tomography and wide-area transepithelial sampling) to reduce the risk of recurrent disease and sampling error, respectively. These uncertainties represent targets for future investigations. pubtype: Academic Journal doctype: review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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