AIM: To investigate whether dysplastic Barrett's Oesophagus can be safely and effectively treated endoscopically in low volume centres after structured training. METHODS: After attending a structured training program in Amsterdam on the endoscopic treatment of dysplastic Barrett's Oesophagus, treatment of these patients was initiated at St Marys Hospital. This is a retrospective case series conducted at a United Kingdom teaching Hospital, of patients referred for endoscopic treatment of Barrett's oesophagus with high grade dysplasia or early cancer, who were diagnosed between January 2008 and February 2012. Data was collected on treatment provided (radiofrequency ablation and endoscopic resection), and success of treatment both at the end of treatment and at follow up. Rates of immediate and long term complications were assessed. RESULTS: Thirty-two patients were referred to St Marys with high grade dysplasia or intramucosal cancer within a segment of Barrett's Oesophagus. Twenty-seven met the study inclusion criteria, 16 of these had a visible nodule at initial endoscopy. Treatment was given over a median of 5 mo, and patients received a median of 3 treatment sessions over this time. At the end of treatment dysplasia was successfully eradicated in 96% and intestinal metaplasia in 88%, on per protocol analysis. Patients were followed up for a median of 18 mo. At which time complete eradication of dysplasia was maintained in 86%. Complications were rare: 2 patients suffered from post-procedural bleeding, 4 cases were complicated by oesophageal stenosis. Recurrence of cancer was seen in 1 case. CONCLUSION: With structured training good outcomes can be achieved in low volume centres treating dysplastic Barrett's Oesophagus.
AIM: To investigate whether dysplastic Barrett's Oesophagus can be safely and effectively treated endoscopically in low volume centres after structured training. METHODS: After attending a structured training program in Amsterdam on the endoscopic treatment of dysplastic Barrett's Oesophagus, treatment of these patients was initiated at St Marys Hospital. This is a retrospective case series conducted at a United Kingdom teaching Hospital, of patients referred for endoscopic treatment of Barrett's oesophagus with high grade dysplasia or early cancer, who were diagnosed between January 2008 and February 2012. Data was collected on treatment provided (radiofrequency ablation and endoscopic resection), and success of treatment both at the end of treatment and at follow up. Rates of immediate and long term complications were assessed. RESULTS: Thirty-two patients were referred to St Marys with high grade dysplasia or intramucosal cancer within a segment of Barrett's Oesophagus. Twenty-seven met the study inclusion criteria, 16 of these had a visible nodule at initial endoscopy. Treatment was given over a median of 5 mo, and patients received a median of 3 treatment sessions over this time. At the end of treatment dysplasia was successfully eradicated in 96% and intestinal metaplasia in 88%, on per protocol analysis. Patients were followed up for a median of 18 mo. At which time complete eradication of dysplasia was maintained in 86%. Complications were rare: 2 patients suffered from post-procedural bleeding, 4 cases were complicated by oesophageal stenosis. Recurrence of cancer was seen in 1 case. CONCLUSION: With structured training good outcomes can be achieved in low volume centres treating dysplastic Barrett's Oesophagus.
Authors: Nicholas J Shaheen; Bergein F Overholt; Richard E Sampliner; Herbert C Wolfsen; Kenneth K Wang; David E Fleischer; Virender K Sharma; Glenn M Eisen; M Brian Fennerty; John G Hunter; Mary P Bronner; John R Goldblum; Ana E Bennett; Hiroshi Mashimo; Richard I Rothstein; Stuart R Gordon; Steven A Edmundowicz; Ryan D Madanick; Anne F Peery; V Raman Muthusamy; Kenneth J Chang; Michael B Kimmey; Stuart J Spechler; Ali A Siddiqui; Rhonda F Souza; Anthony Infantolino; John A Dumot; Gary W Falk; Joseph A Galanko; Blair A Jobe; Robert H Hawes; Brenda J Hoffman; Prateek Sharma; Amitabh Chak; Charles J Lightdale Journal: Gastroenterology Date: 2011-05-06 Impact factor: 22.682
Authors: R J Schlemper; R H Riddell; Y Kato; F Borchard; H S Cooper; S M Dawsey; M F Dixon; C M Fenoglio-Preiser; J F Fléjou; K Geboes; T Hattori; T Hirota; M Itabashi; M Iwafuchi; A Iwashita; Y I Kim; T Kirchner; M Klimpfinger; M Koike; G Y Lauwers; K J Lewin; G Oberhuber; F Offner; A B Price; C A Rubio; M Shimizu; T Shimoda; P Sipponen; E Solcia; M Stolte; H Watanabe; H Yamabe Journal: Gut Date: 2000-08 Impact factor: 23.059
Authors: Frederik Hvid-Jensen; Lars Pedersen; Asbjørn Mohr Drewes; Henrik Toft Sørensen; Peter Funch-Jensen Journal: N Engl J Med Date: 2011-10-13 Impact factor: 91.245
Authors: Virender K Sharma; H Jae Kim; Ananya Das; Christopher D Wells; Cuong C Nguyen; David E Fleischer Journal: Am J Gastroenterol Date: 2009-01-27 Impact factor: 10.864
Authors: S J Spechler; A H Robbins; H B Rubins; M E Vincent; T Heeren; W G Doos; T Colton; E M Schimmel Journal: Gastroenterology Date: 1984-10 Impact factor: 22.682
Authors: J J Gondrie; R E Pouw; C M T Sondermeijer; F P Peters; W L Curvers; W D Rosmolen; K K Krishnadath; F Ten Kate; P Fockens; J J Bergman Journal: Endoscopy Date: 2008-05 Impact factor: 10.093
Authors: Nicholas J Shaheen; Prateek Sharma; Bergein F Overholt; Herbert C Wolfsen; Richard E Sampliner; Kenneth K Wang; Joseph A Galanko; Mary P Bronner; John R Goldblum; Ana E Bennett; Blair A Jobe; Glenn M Eisen; M Brian Fennerty; John G Hunter; David E Fleischer; Virender K Sharma; Robert H Hawes; Brenda J Hoffman; Richard I Rothstein; Stuart R Gordon; Hiroshi Mashimo; Kenneth J Chang; V Raman Muthusamy; Steven A Edmundowicz; Stuart J Spechler; Ali A Siddiqui; Rhonda F Souza; Anthony Infantolino; Gary W Falk; Michael B Kimmey; Ryan D Madanick; Amitabh Chak; Charles J Lightdale Journal: N Engl J Med Date: 2009-05-28 Impact factor: 91.245
Authors: Rebecca C Fitzgerald; Massimiliano di Pietro; Krish Ragunath; Yeng Ang; Jin-Yong Kang; Peter Watson; Nigel Trudgill; Praful Patel; Philip V Kaye; Scott Sanders; Maria O'Donovan; Elizabeth Bird-Lieberman; Pradeep Bhandari; Janusz A Jankowski; Stephen Attwood; Simon L Parsons; Duncan Loft; Jesper Lagergren; Paul Moayyedi; Georgios Lyratzopoulos; John de Caestecker Journal: Gut Date: 2013-10-28 Impact factor: 23.059