Cryoablation of Barrett's esophagus: a pilot study.

摘要: Background Numerous ablative modalities have demonstrated varying degrees of efficacy in the eradication Barrett's esophagus (BE). However, they are associated with either high cost, patient discomfort, complications, tedious application, residual underlying BE, or some combination above. The aim this study was to evaluate safety and a new cryogenic device by using liquid nitrogen sprayed through an open tipped catheter placed accessory channel upper endoscope. Methods A prospective, single center performed on patients long-standing history BE followed registry. Patients dysplasia ranging from none multifocal high-grade were treated. All treated 40 mg rabeprazole 3 times per day during treatment period. Elimination acid reflux confirmed via 24-hour esophageal pH studies. Cryoablation applied hemicircumferentially 4-cm-long segments at monthly intervals, until entire segment eliminated. Results Eleven There reversal all patients. In 9 11 (78%) who completed protocol, there complete endoscopic histologic BE. no subsquamous specialized intestinal metaplasia 6-month follow-up. No complications occurred. Conclusions Based preliminary results, low-pressure spray cryoablation under direct visualization is safe easy perform. Its relative lack discomfort its simplicity make it modality that should be further explored ablation GI mucosal lesions such as perhaps early cancer.