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Treatment of dysplasia in barrett esophagus.

Aranda-Hernandez J, Cirocco M, Marcon N - Clin Endosc (2014)

Bottom Line: Most of these patients present de novo and are not part of a surveillance program.Endoscopic techniques such as endoscopic mucosal resection and radiofrequency ablation have resulted in high curative rates and a shift away from esophagectomy.This pathway is supported by the literature review of esophagectomies performed for mucosal disease, as well as pathologists' interpretation of endoscopic mucosal specimens, which document the low risk of lymph node metastasis.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Medicine, The Center of Advanced Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, University of Toronto Faculty of Medicine, Toronto, ON, Canada.

ABSTRACT
Barrett esophagus is recognized as a risk factor for the development of dysplasia and adenocarcinoma of the esophagus. Cancer is usually diagnosed at an advanced stage with a 5-year survival rate of 15%. Most of these patients present de novo and are not part of a surveillance program. Endoscopic screening with improvement in recognition of early lesions may change this pattern. In the past, patients diagnosed with dysplasia and mucosal cancer were best managed by esophagectomy. Endoscopic techniques such as endoscopic mucosal resection and radiofrequency ablation have resulted in high curative rates and a shift away from esophagectomy. This pathway is supported by the literature review of esophagectomies performed for mucosal disease, as well as pathologists' interpretation of endoscopic mucosal specimens, which document the low risk of lymph node metastasis. The role of endoscopic therapy for superficial submucosal disease continues to be a challenge.

No MeSH data available.


Related in: MedlinePlus

(A) Nonnodular long segment of Barrett esophagus. (B) HALO 360 device immediately after deflation. (C) Mucosa immediately post-application.
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Figure 3: (A) Nonnodular long segment of Barrett esophagus. (B) HALO 360 device immediately after deflation. (C) Mucosa immediately post-application.

Mentions: The HALO system (BÂRRX Medical Covidien Inc., Sunnyvale, CA, USA) is available in several formats. Cylindrical balloons (HALO 360) are ideal for circumferential and long segments of BE (Fig. 3). Focal ablation devices (HALO 90 and HALO 60) of different lengths that fit over the endoscope tip can be used for short circumferential segments, tongues, or residual islands (Fig. 4). Recently, a through the scope ablation device (HALO-TTS) has been developed to complement the other focal devices and is easier and quicker to use.


Treatment of dysplasia in barrett esophagus.

Aranda-Hernandez J, Cirocco M, Marcon N - Clin Endosc (2014)

(A) Nonnodular long segment of Barrett esophagus. (B) HALO 360 device immediately after deflation. (C) Mucosa immediately post-application.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928493&req=5

Figure 3: (A) Nonnodular long segment of Barrett esophagus. (B) HALO 360 device immediately after deflation. (C) Mucosa immediately post-application.
Mentions: The HALO system (BÂRRX Medical Covidien Inc., Sunnyvale, CA, USA) is available in several formats. Cylindrical balloons (HALO 360) are ideal for circumferential and long segments of BE (Fig. 3). Focal ablation devices (HALO 90 and HALO 60) of different lengths that fit over the endoscope tip can be used for short circumferential segments, tongues, or residual islands (Fig. 4). Recently, a through the scope ablation device (HALO-TTS) has been developed to complement the other focal devices and is easier and quicker to use.

Bottom Line: Most of these patients present de novo and are not part of a surveillance program.Endoscopic techniques such as endoscopic mucosal resection and radiofrequency ablation have resulted in high curative rates and a shift away from esophagectomy.This pathway is supported by the literature review of esophagectomies performed for mucosal disease, as well as pathologists' interpretation of endoscopic mucosal specimens, which document the low risk of lymph node metastasis.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Medicine, The Center of Advanced Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, University of Toronto Faculty of Medicine, Toronto, ON, Canada.

ABSTRACT
Barrett esophagus is recognized as a risk factor for the development of dysplasia and adenocarcinoma of the esophagus. Cancer is usually diagnosed at an advanced stage with a 5-year survival rate of 15%. Most of these patients present de novo and are not part of a surveillance program. Endoscopic screening with improvement in recognition of early lesions may change this pattern. In the past, patients diagnosed with dysplasia and mucosal cancer were best managed by esophagectomy. Endoscopic techniques such as endoscopic mucosal resection and radiofrequency ablation have resulted in high curative rates and a shift away from esophagectomy. This pathway is supported by the literature review of esophagectomies performed for mucosal disease, as well as pathologists' interpretation of endoscopic mucosal specimens, which document the low risk of lymph node metastasis. The role of endoscopic therapy for superficial submucosal disease continues to be a challenge.

No MeSH data available.


Related in: MedlinePlus