Intraepithelial High-Grade Neoplasia and Early Adenocarcinoma in Short-Segment Barrett’s Esophagus (SSBE): Curative Treatment Using Local Endoscopic Treatment Techniques

• DOI: 10.1055/s-2002-33236
• Publication Date: 2002-09-18T00:10:29Z
• Authors: A. May; L. Gossner; O. Pech; H. Müller; M. Vieth; M. Stolte; C. Ell
• Keywords: Barrett's esophagus; Perforation; Endoscopic mucosal resection

In recent years, short-segment Barrett's esophagus (SSBE) has attracted increasing attention in the context of reflux disease. However, there is continuing controversy regarding its potential for malignant transformation.Between October 1996 and September 1999, 50/115 patients (43 %) with intraepithelial high-grade neoplasia or early adenocarcinoma, who underwent local endoscopic treatment, had developed a lesion an (SSBE). framework prospective observational study, 28 were treated mucosal resection (EMR), 13 photodynamic therapy, three argon plasma coagulation; six received combinations these treatments.Complete remission was achieved 48/49 (98 %). One patient switched to surgery after first EMR, because submucosal tumor infiltration, one out 50 treatment failed. A mean 1.7 +/- 1.4 sessions required treatment. The method-associated mortality 0 %. rate relevant complications (stenosis, bleeding) 6 % (3/50 patients). No cases severe hemorrhage (Hb fall >2 g/dl) perforation occurred. During follow-up period 34 10 months, metachronous neoplasms adenocarcinomas seen 11/48 (23 %), further successful Four died during period, but only this due his adenocarcinoma (this esophageal resection).The must not be underestimated. Organ-preserving shows good acute-phase long-term results. Local represents alternative case selected esophagus.