The researchers assessed the efficacy and safety of multipolar electrocoagulation combined with high-dose acid inhibition for treatment of Barrett's esophagus.
They reported their findings in the May issue of Gastrointestinal Endoscopy.
Patients with a 2 to 6 cm segment of Barrett's esophagus without dysplasia were enrolled at 3 centers.
They were treated with omeprazole 40 mg twice daily and then with up to 6 sessions with electrocoagulation aimed at eliminating all the endoscopically apparent Barrett's.
4 quadrant large-capacity biopsies every 2 cm were centrally assessed for residual intestinal metaplasia.
58 patients were found to reach the endpoint of failure of visual reversal of Barrett's after 6 treatment sessions or a 6-month follow-up after the last session.
85% had visual reversal of Barrett's and 78% both visual and histologic reversal.
|Reversal of Barrett's after treatment: |
Visual reversal: 85%
Visual and histologic: 78%
The researchers found that 4 patients had histologic evidence of residual intestinal metaplasia.
Transient esophageal symptoms were common amongst subjects.
One patient developed a stricture requiring dilation and one required overnight hospitalization for chest pain.
Richard E. Sampliner, of the Southern Arizona VA Health Care System, concluded on behalf of the group, "The majority of patients with 2- to 6-cm of nondysplastic Barrett's esophagus can be safely reversed with this combination therapy.
"Long-term follow-up will be necessary to document the durability of the new squamous epithelium."