The treatment of the patients presenting with Barrett’s oesophagus

Close metadata

Recommended articles:

Early adenocarcinoma in Barrett’s esophagus with implantation metastasis. (A case report). Russian Journal of Evidence-Based Gastroenterology. 2024;(1):101-107

The problem of diagnostics of Barrett’s oesophagus (BE) and care provision for the patients presenting with this condition has attracted close attention during the recent years due to the ever increasing fraction of adenocarcinomas among the malignant tumours of the oesophagus. Generally speaking, the risk of development of oesophageal adenocarcinoma in the patients with BE is relatively insignificant in the absence of epithelial dysplasia; however, it markedly increases with the progression of dysplastic changes. It suggests the necessity of detection of the intestinal metaplasia segment for the choice of the strategy for the management of the patients suffering from Barrett’s oesophagus. The authors describe the clinical cases of Barrett’s oesophagus with concomitant dysplasia and the treatment of this condition during the intravital endoscopic intervention that were reported at the 17th international conference «The application of high technologies for endoscopy of the digestive system» held at Yaroslavl on the 30th of June 2017.

Keywords:

Barrett’s oesophagus

dysplasia

endoscopic resection endoscopic ablation

Authors:

Kashin S.V.

ORCID: 0000-0001-6098-7677

Vidyaeva N.S.

Yaroslavl Regional Clinical Oncological Hospital, Yaroslavl, Russia

Kuvaev R.O.

ORCID: 0000-0002-0070-9066

Krainova E.A.

State budgetary healthcare facility «Yaroslavl’ Regional Clinical Oncological Hospital»

Haidri R.

University of London Clinic, London, Great Britain

Ragunat K.

University of Nottingham Clinic, Nottingham, Great Britain

Manner H.

HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany

List of references:

Ivashkin VT, Maev IV, Trukhmanov AS, Sokolov VV, PirogovSS, Zairat’yants OV, Sheptulin AA, Lapina TL, Zairat’yants GO, Kaibysheva VO. Profil’naya komissiya RGA po spetsial’nosti «Gastroenterologiya» Ministerstva zdravookhraneniya Rossiiskoi Federatsii.Rossiiskaya gastroenterologicheskaya assotsiatsiya. Pishchevod Barreta. Klinicheskie rekomendatsii. M.: 2014. Accessed: November 11, 2017. (In Russ.) https://www.gastroscan.ru/literature/authors/8444
Ivashkin VT, Maev IV, Trukhmanov AS. Pishchevod Barreta. V dvukh tomakh. M.: Shiko; 2011, t. 2, 69-71. (In Russ.)
Ivashkin VT, Maev IV, Trukhmanov AS, Baranskaya EK, Dronova OB, Zairat’yants OV, Pasechnikov VD, Saifutdinov RG, Sheptulin AA, Kucheryavyi YuA, Lapina TL, Storonova OA, Kaibysheva VO. Profil’naya komissiya RGA po spetsial’nosti «Gastroenterologiya» Ministerstva zdravookhraneniya Rossiiskoi Federatsii. Rossiiskaya gastroenterologicheskaya assotsiatsiya. Gastroezofageal’naya reflyuksnaya bolezn’. Klinicheskie rekomendatsii. M.; 2014. Accessed: November 11, 2017. (In Russ.) http://www.gastroscan.ru/literature/authors/7752
Fitzgerald RC, di Pietro M, Ragunath K, Ang Y, Kang JY, Watson P, Trudgill N, Patel P, Kaye PV, Sanders S, O’Donovan M, Bird-Lieberman E, Bhandari P,Jankowski JA, Attwood S, Parsons SL, Loft D, Lagergren J, Moayyedi P, Lyratzopoulos G, de Caestecker J. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett’s oesophagus. Gut. 2014;63(1):7-42. https://doi.org/10.1136/gutjnl-2013-305372
Nikonov EL, Kuvaev RO, Kashin SV. Barrett’s oesophagus: the currently available possibilities for the medication therapy management and the new method for endoscopic therapy. Dokazatel’naya gastroenterologiya. 2014;3(3):19-24. (In Russ.)
Curvers WL, Singh R, Song LM, Wolfsen HC, Ragunath K, Wang K, Wallace MB, Fockens P, Bergman JJ. Endoscopic tri-modal imaging for detection of early neoplasia in Barrett’s oesophagus: a multi-centre feasibility study using high-resolution endoscopy, autofluorescence imaging and narrow band imaging incorporated in one endoscopy system. Gut. 2007;57(2):167-172. https://doi.org/10.1136/gut.2007.134213
Curvers WL, Alvarez Herrero L, Wallace MB, Wong Kee Song LM, Ragunath K, Wolfsen HC, Prasad GA, Wang KK, Subramanian V, Weusten BL, Ten Kate FJ, Bergman JJ. Endoscopic tri-modal imaging is more effective than standard endoscopy in identifying early-stage neoplasia in Barrett’s esophagus. Gastroenterology. 2010;139(4):1106-1114. https://doi.org/10.1053/j.gastro.2010.06.045
Fitzgerald RC, di Pietro M, Ragunath K, Ang Y, Kang JY, Watson P, Trudgill N, Patel P, Kaye PV, Sanders S, O’Donovan M, Bird-Lieberman E, Bhandari P,Jankowski JA, Attwood S, Parsons SL, Loft D, Lagergren J, Moayyedi P, Lyratzopoulos G, de Caestecker J. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett’s oesophagus. Gut. 2014;63(1):7-42. https://doi.org/10.1136/gutjnl-2013-305372
Peters FP, Brakenhoff KP, Curvers WL, Rosmolen WD, Fockens P, ten Kate FJ, Krishnadath KK, Bergman JJ. Peters FP. Histologic evaluation of resection specimens obtained at 293 endoscopic resections in Barrett’s esophagus. Gastrointestinal Endoscopy. 2008;67(4):604-609. https://doi.org/10.1016/j.gie.2007.08.039
Ormsby AH, Petras RE, Henricks WH, Rice TW, Rybicki LA, Richter JE, Goldblum JR. Observer variation in the diagnosis of superficial oesophageal adenocarcinoma. Gut. 2002;51(5):671-676. https://doi.org/10.1136/gut.51.5.671
Downs-Kelly E, Mendelin JE, Bennett AE, Castilla E, Henricks WH, Schoenfield L, Skacel M, Yerian L, Rice TW, Rybicki LA, Bronner MP, Goldblum JR. Poor interobserver agreement in the distinction of high-grade dysplasia and adenocarcinoma in pretreatmentBarrett’s esophagus biopsies. The American Journal of Gastroenterology. 2008;103(9):2333-2340;quiz 2341. https://doi.org/10.1111/j.1572-0241.2008.02020.x
Bergman J, Fockens P. Management of HGIN in Barrett’s Esophagus. In: Sharma P., Sampliner R. eds. Barrett’s Esophagus and Esophageal Adenocarcinoma. 2nd ed, USA: Blackwell Publishing; 2006. https://doi.org/10.1002/9780470987513
Conio M, Repici A, Cestari R, Blanchi S, Lapertosa G, Missale G, Della Casa D, Villanacci V, Calandri PG, Filiberti R. Endoscopic mucosal resection for high-grade dysplasia and intramucosal carcinoma in Barrett’s esophagus: an Italian experience. World Journal of Gastroenterology. 2005;11(42):6650-6655. https://doi.org/10.3748/wjg.v11.i42.6650
Mino-Kenudson M, Brugge WR, Puricelli WP, Nakatsuka LN, Nishioka NS, Zukerberg LR, Misdraji J, Lauwers GY. Management of superficial Barrett’s epithelium-related neoplasms by endoscopic mucosalresection: clinicopathologic analysis of 27 cases. American Journal of Surgical Pathology. 2005;29(5):680-686. https://doi.org/10.1097/01.pas.0000154129.87219.fa
Bulsiewicz WJ, Cotton CC, Dellon ES, Spacek MB, Chen X, Madanick RD, Pasricha S, Shaheen NJ. Focal endoscopic mucosal resection before radiofrequency ablation is equally effective and safe comparedwith radiofrequency ablation alone for the eradication of Barrett’s esophagus with advanced neoplasia. Gastrointestinal Endoscopy. 2012;76(4):733-739. https://doi.org/10.1016/j.gie.2012.04.459
Haidry RJ, Lipman G, Banks MR, Butt MA, Sehgal V, Graham D, Dunn JM, Gupta A, Sweis R, Miah H, Morris D, Smart HL, Bhandari P, Willert R, Fullarton G, Morris J, Di Pietro M, Gordon C, Penman I, Barr H, Patel P, Boger P, Kapoor N, Mahon B, Hoare J, Narayanasamy R, O’Toole D, Cheong E, Direkze NC, Ang Y, Veitch A, Dhar A, Nyalender D, Ragunath K, Leahy A, Fullard M, Rodriguez-Justo M, Novelli M, Lovat LB. Comparing outcome of radiofrequency ablation in Barrett’s with high grade dysplasia and intramucosal carcinoma: a prospective multicenter UK registry. Endoscopy. 2015;47(11):980-987. https://doi.org/10.1055/s-0034-1392414
Conio M, Repici A, Cestari R. Endoscopic mucosal resection for high-grade dysplasia and intramucosal carcinoma in Barrett’s esophagus: an Italian experience. World Journal of Gastroenterology. 2005;11(42):6650. https://doi.org/10.3748/wjg.v11.i42.6650
Pouw RE, van Vilsteren FG, Peters FP, Alvarez Herrero L, Ten Kate FJ, Visser M, Schenk BE, Schoon EJ, Peters FT, Houben M, Bisschops R, Weusten BL, Bergman JJ. Randomized trial on endoscopic resection-cap versus multiband mucosectomy for piecemeal endoscopic resection of early Barrett’s neoplasia. Gastrointestinal Endoscopy. 2011;74(1):35-43. https://doi.org/10.1016/j.gie.2011.03.1243
Shaheen NJ, Falk GW, Iyer PG, Gerson LB. ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus. The American Journal of Gastroenterology. 2016;111(1):30-50;quiz 51. https://doi.org/10.1038/ajg.2015.322
Manner H, Rabenstein T, Pech O, Braun K, May A, Pohl J, Behrens A, Vieth M, Ell C. Ablation of remaining Barrett’s epithelium after endoscopic resection: a randomized long-term follow-up study on argon plasma coagulation versus surveillance (APE study). Endoscopy. 2014;46(1):6-12. https://doi.org/10.1055/s-0033-1358813
Pouw RE, Wirths K, Eisendrath P, Sondermeijer CM, Ten Kate FJ, Fockens P, Devière J, Neuhaus H, Bergman JJ. Efficacy of radiofrequency ablation combined with endoscopic resection for barrett’s esophagus with early neoplasia. Clinical Gastroenterology and Hepatology. 2010;8(1):23-29. https://doi.org/10.1016/j.cgh.2009.07.003
Pech O, May A, Manner H, Behrens A, Pohl J, Weferling M, Hartmann U, Manner N, Huijsmans J, Gossner L, Rabenstein T, Vieth M, Stolte M,Ell C. Long-term efficacy and safety of endoscopic resection for patients with mucosal adenocarcinoma of the esophagus. Gastroenterology. 2014;146(3):652-660.e1. https://doi.org/10.1053/j.gastro.2013.11.006
Phoa KN, Pouw RE, Bisschops R, Pech O, Ragunath K, Weusten BL, Schumacher B, Rembacken B, Meining A, Messmann H, Schoon EJ,Gossner L, Mannath J, Seldenrijk CA, Visser M, Lerut T, Seewald S, ten Kate FJ, Ell C, Neuhaus H, Bergman JJ. Multimodality endoscopic eradication for neoplastic Barrett oesophagus: results of an European multicentrestudy (EURO-II). Gut. 2016;65(4):555-562. https://doi.org/10.1136/gutjnl-2015-309298
van Vilsteren FG¹, Alvarez Herrero L, Pouw RE, Visser M, Ten Kate FJ, van Berge Henegouwen MI, Schoon EJ, Weusten BL, Bergman JJ. Radiofrequency ablation and endoscopic resection in a single session for Barrett’s esophagus containing early neoplasia: a feasibility study. Endoscopy. 2012;44(12):1096-1104. https://doi.org/10.1055/s-0032-1325731
Barret M, Belghazi K, Weusten BL, Bergman JJ, Pouw RE. Single-session endoscopic resection and focal radiofrequency ablation for short-segment Barrett’s esophaguswith early neoplasia. Gastrointestinal Endoscopy. 2016;84(1):29-36. https://doi.org/10.1016/j.gie.2015.12.034
Duits LC, Phoa KN, Curvers WL, Ten Kate FJ, Meijer GA, Seldenrijk CA, Offerhaus GJ, Visser M, Meijer SL, Krishnadath KK, Tijssen JG, Mallant-Hent RC, Bergman JJ. Barrett’s oesophagus patients with low-grade dysplasia can be accurately risk-stratified after histological review by an expert pathology panel. Gut. 2015;64(5):700-706. https://doi.org/10.1136/gutjnl-2014-307278
Curvers WL, ten Kate FJ, Krishnadath KK, Visser M, Elzer B, Baak LC, Bohmer C, Mallant-Hent RC, van Oijen A, Naber AH, Scholten P, Busch OR,Blaauwgeers HG, Meijer GA, Bergman JJ. Low-grade dysplasia in Barrett’s esophagus: overdiagnosed and underestimated. The American Journal of Gastroenterology. 2010;105(7):1523-1530. https://doi.org/10.1038/ajg.2010.171
Phoa KN, van Vilsteren FG, Weusten BL, Bisschops R, Schoon EJ, Ragunath K, Fullarton G, Di Pietro M, Ravi N, Visser M, Offerhaus GJ,Seldenrijk CA, Meijer SL, ten Kate FJ, Tijssen JG, Bergman JJ. Radiofrequency Ablation vs Endoscopic Surveillance for Patients With Barrett Esophagus and Low-Grade Dysplasia. The Journal of the American Medical Association. 2014;311(12):1209-1217. https://doi.org/10.1001/jama.2014.2511
British Society of Gastroenterology Guidelines on the Diagnosis and Management of Barrett’s Oesophagus — An Update. Accessed: November 11, 2017. Available at: https://www.bsg.org.uk/clinical-guidelines/oesophageal/guidelines-on-the-diagnosis-and-management-of-barrett-s-oesophagus.html

Close metadata