Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Recurrence of esophageal intestinal metaplasia after treatment of Barrett's

This month's issue of Gastroenterology examines the recurrence of esophageal intestinal metaplasia after endoscopic mucosal resection and radiofrequency ablation of Barrett's esophagus.

News image

Radiofrequency ablation is an established treatment for dysplastic Barrett's esophagus.

Although short-term end points of ablation have been ascertained, there have been concerns about recurrence of intestinal metaplasia after ablation.

Dr Milli Gupta and colleagues from Minnesota, USA estimated the incidence and identified factors that predicted the recurrence of  intestinal metaplasia  after successful radiofrequency ablation.

The researchers analyzed data from 592 patients with Barrett's esophagus treated with radiofrequency ablation from 2003 through 2011 at 3 tertiary referral centers.

The doctors defined complete remission of intestinal metaplasia as eradication of intestinal metaplasia, documented by 2 consecutive endoscopies.

Recurrence was defined as the presence of intestinal metaplasia or dysplasia after complete remission of intestinal metaplasia  in surveillance biopsies.

There were 2 experienced gastrointestinal pathologists that confirmed pathology findings.

The doctors noted that based on histology analysis, before radiofrequency ablation, 71% of patients had high-grade dysplasia or esophageal adenocarcinoma, 15% had low-grade dysplasia, and 14% had nondysplastic Barrett's esophagus.

Of patients treated, 448 were assessed after radiofrequency ablation.

There were 55% of patients who underwent endoscopic mucosal resection before radiofrequency ablation.

22% of all recurrences observed were dysplastic Barrett's esophagus
Gastroenterology

The researchers found that the median time to complete remission of intestinal metaplasia  was 22 months, with 56% of patients in complete remission of intestinal metaplasia  by 24 months.

Increasing age and length of Barrett's esophagus segment were associated with longer times to complete remission of intestinal metaplasia.

The team noted that 24 months after complete remission of intestinal metaplasia, the incidence of recurrence was 33%.

The researchers found that 22% of all recurrences observed were dysplastic Barrett's esophagus.

The doctors noted that there were no demographic or endoscopic factors associated with recurrence.

Complications developed in 6.5% of subjects treated with radiofrequency ablation, and strictures were the most common complication.

Dr Gupta's team commented, "Of patients with Barrett's esophagus treated by radiofrequency ablation , 56% were in complete remission after 24 months."

"However, 33% of these patients had disease recurrence within the next 2 years."

"Most recurrences were nondysplastic and endoscopically manageable, but continued surveillance after Radiofrequency ablation is essential."

Gastroenterol 2013: 145(1): 79-86
12 July 2013

Go to top of page Email this page Email this page to a colleague

 05 March 2015

Advanced search
 05 March 2015 
Neuroendocrine carcinoma of the colon and rectum
 05 March 2015 
Infliximab and immunosuppressant therapy in ulcerative colitis
 05 March 2015 
EPHXI polymorphism and esophageal cancer risk
 04 March 2015 
Management of IBD
 04 March 2015 
Multidisciplinary management of rectal cancer
 04 March 2015 
Progression of Barrett's
 03 March 2015 
EPHX1 polymorphism and esophageal cancer risk
 03 March 2015 
GI bleeding in chronic kidney disease patients on aspirin
 03 March 2015 
Risk of anastomotic leak after colectomy
 02 March 2015 
Genes and early diagnosis of IBD
 02 March 2015 
Assessment of GERD
 02 March 2015 
Liver disease in patients awaiting liver transplant
 27 February 2015 
Obesity and weight-loss therapy
 27 February 2015 
MRE performance in staging liver fibrosis
 27 February 2015 
Bleeding in diverticulosis
 26 February 2015 
Familial colorectal cancer risk and primary cancer
 26 February 2015 
Herbal products and the liver
 26 February 2015 
Questionnaires for GERD
 25 February 2015 
Exercise and NAFLD
 25 February 2015 
IBD in Korea
 25 February 2015 
Immunosuppressive therapy and T. whipplei
 24 February 2015 
Clinical trials in pediatric IBD
 24 February 2015 
Reducing health care costs in IBD
 24 February 2015 
GI bleeding after anticoagulation interruption
 23 February 2015 
Visceral abdominal obesity and IBS
 23 February 2015 
Crohn's outcomes with infliximab
 23 February 2015 
Intestinal microbiota and celiac disease
 20 February 2015 
H. pylori eradication
 20 February 2015 
Antiviral treatment and Hep C outcomes
 20 February 2015 
C. diff testing in IBD
 19 February 2015 
Peptic ulcer bleeding mortality in liver disease
 19 February 2015 
Intestinal microbiota in IBS
 19 February 2015 
Fecal microbial transplant in active Crohn's disease
 18 February 2015 
Genetic testing and GI cancers
 18 February 2015 
Placebo analgesia in functional abdominal pain
 18 February 2015 
Successful Hep C virus therapy
 17 February 2015 
Quality measures and colonoscopist selection
 17 February 2015 
Global incidence of esophageal cancer
 17 February 2015 
Anti-viral treatment and survival in Hep C
 16 February 2015 
Saliva for the diagnosis of GERD
 16 February 2015 
H pylori eradication therapy
 16 February 2015 
Medical marijuana for digestive disorders
 13 February 2015 
Beta-blockers in cirrhosis
 13 February 2015 
Liver disease and peptic ulcer bleeding
 13 February 2015 
Prevalence of microscopic colitis
 12 February 2015 
Liver disease in chronic Hep C
 12 February 2015 
Patient-reported outcomes in Hep C
 12 February 2015 
Patientsí colonoscopist selection
 11 February 2015 
Hepatic decompensation in Hep C cirrhosis
 11 February 2015 
Guidelines for the diagnosis of hepatocellular carcinoma
 11 February 2015 
NAFLD and CVD
 10 February 2015 
Percutaneous endoscopic gastrostomy
 10 February 2015 
Factors that influence hepatic steatosis
 10 February 2015 
Gene variants and Crohn's susceptibility
 09 February 2015 
Factors that influence gallstone surgery
 09 February 2015 
Factors associated with increased mortality in cirrhosis
 09 February 2015 
Use of immunomodulators in IBD
 06 February 2015 
Colorectal cancer risk in IBD
 06 February 2015 
H. pylori and peptic ulcer bleeding
 06 February 2015 
IBS and somatization

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us