Argon plasma coagulation seems to be a promising technique for ablation of Barrett's esophagus.
However, few long-term efficacy data are available.
Dr Ferraris and colleagues from Italy assessed the factors that determine the recurrence of intestinal metaplasia in patients with non dysplastic, and intestinal type Barrett's esophagus.
The researchers evaluated patients after complete ablation of the metaplastic mucosa with argon plasma coagulation.
|18% of patients had recurrence of intestinal metaplasia|
|Alimentary Pharmacology & Therapeutics|
The team assessed 96 patients who underwent endoscopic argon plasma coagulation with adequate acid suppression .
Acid suppression was obtained through a continuous omeprazole therapy in 50 patients, or through laparoscopic fundoplication in 46 patients.
The team observed that complete ablation was achieved in 94 patients who underwent follow-up.
Endoscopic and histological examinations were performed every 12 months.
The researchers noted that the median follow-up of the patients was 36 months.
The team observed a recurrence of intestinal metaplasia in 18% of patients, with an annual recurrence rate of 6%.
The researchers found neither dysplasia, nor adenocarcinoma during the follow-up.
After further analysis, the team found that previous laparoscopic fundoplication was associated with a reduced recurrence rate of intestinal metaplasia.
Dr Ferraris' team commented, “The long-term recurrence of intestinal type Barrett's esophagus was low after complete ablation with argon plasma coagulation.”
“The control of esophageal acidity acid exposure with laparoscopic fundoplication seems to reduce the recurrence rate.”