Efficacy and safety of liquid nitrogen cryotherapy for treatment of Barrett’s esophagus
| Autor: | John M. Levenick, Kristen Suchniak-Mussari, Thomas J. McGarrity, Jennifer L. Maranki, Abraham Mathew, Matthew T. Moyer, Eileen M. Gagliardi, Charles Dye |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Radiofrequency ablation medicine.medical_treatment Cryotherapy Chest pain Liquid nitrogen cryotherapy law.invention 03 medical and health sciences 0302 clinical medicine law Retrospective Study medicine Barrett’s esophagus Esophagus Adverse effect business.industry Intestinal metaplasia medicine.disease Surgery medicine.anatomical_structure Dysplasia 030220 oncology & carcinogenesis Barrett's esophagus TruFreeze 030211 gastroenterology & hepatology Esophageal adenocarcinoma medicine.symptom business |
| Zdroj: | World Journal of Gastrointestinal Endoscopy |
| ISSN: | 1948-5190 |
| Popis: | Aim To evaluate the efficacy and safety of liquid nitrogen cryotherapy as a primary or rescue treatment for BE, with and without dysplasia, or intramucosal adenocarcinoma (IMC). Methods This was a retrospective, single-center study carried out in a tertiary care center including 45 patients with BE who was treatment-naive or who had persistent intestinal metaplasia (IM), dysplasia, or IMC despite prior therapy. Barrett's mucosa was resected via EMR when clinically appropriate, then patients underwent cryotherapy until eradication or until deemed to have failed treatment. Surveillance biopsies were taken at standard intervals. Results From 2010 through 2014, 33 patients were studied regarding the efficacy of cryotherapy. Overall, 29 patients (88%) responded to cryotherapy, with 84% having complete regression of all dysplasia and cancer. Complete eradication of cancer and dysplasia was seen in 75% of subjects with IMC; the remaining two subjects did not respond to cryotherapy. Following cryotherapy, 15 patients with high-grade dysplasia (HGD) had 30% complete regression, 50% IM, and 7% low-grade dysplasia (LGD); one subject had persistent HGD. Complete eradication of dysplasia occurred in all 5 patients with LGD. In 5 patients with IM, complete regression occurred in 4, and IM persisted in one. In 136 cryotherapy sessions amongst 45 patients, adverse events included chest pain (1%), stricture (4%), and one gastrointestinal bleed in a patient on dual antiplatelet therapy who had previously undergone EMR. Conclusion Cryotherapy is an efficacious and safe treatment modality for Barrett's esophagus with and without dysplasia or intramucosal adenocarcinoma. |
| Databáze: | OpenAIRE |
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