医学
氩等离子体凝固
外科
射频消融术
发育不良
球囊扩张
挽救疗法
粘膜切除术
内镜黏膜下剥离术
回顾性队列研究
食管
内窥镜检查
烧蚀
内科学
气球
化疗
作者
L. Mesureur,Pierre Henri Deprez,Raf Bisschops,Roos E. Pouw,Bas L. Weusten,Maximilien Barret,Pieter Dewint,David J. Tate,Philippe Leclercq,Stefan Seewald,Federico Barbaro,Francisco Baldaque‐Silva,Masami Omae,Mathieu Pioche,Mariana Figueiredo Ferreira,Michael J. Bourke,Rehan Haidry,Christophe Snauwaert,Pierre Eisendrath,V De Maertelaer,Nicolas Rosewick,Jacques Devière,Arnaud Lemmers
出处
期刊:Endoscopy
[Georg Thieme Verlag KG]
日期:2024-04-16
摘要
Background and study aims: This study evaluated the safety and efficacy of salvage endoscopic submucosal dissection for Barrett’s neoplasia recurrence after radiofrequency ablation. Patients and methods: Data from patients at sixteen centers were collected for a multicentric retrospective study. Patients who underwent at least one RFA treatment for Barrett’s esophagus and thereafter underwent further esophageal ESD for neoplasia recurrence were included. Results: Data from 56 patients treated by salvage ESD performed between April 2014 and November 2022 were collected. Immediate complications included one muscular tear (1.8%) treated with stent (Agree classification: grade IIIa), two patients had transmural perforations (4%) and five patients had muscular tears (9%) treated with clips and without clinical impact and not considered as adverse event. Seven patients (12.5%) developed strictures, treated by balloon dilation (grade IIIa). Histological analysis showed 36 adenocarcinomas, 17 high-grade dysplasia, and 3 low-grade dysplasia. En-bloc and R0 resection rates were 89% and 66%, respectively. Resections were curative in thirty-three patients (59%), non-curative in 22 patients (39%), including 11 “local risk” (19.5%) and 11 “high risk” resections (19.5%). At the end of follow-up with a median time of 14 [0-75] months after salvage ESD eventually associated with further endoscopic treatment (RFA, argon plasma coagulation, endoscopic mucosal resection, ESD), neoplasia remission ratio was 37/53 (70%) and the median remission time was 13 [1-75] months. Conclusion: In expert hands, salvage ESD is a safe and effective treatment for recurrence of Barrett’s neoplasia after RFA treatment.
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