Brief Reports
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2005; 11(8): 1182-1186
Published online Feb 28, 2005. doi: 10.3748/wjg.v11.i8.1182
Long-term follow-up after complete ablation of Barrett’s esophagus with argon plasma coagulation
Ahmed Madisch, Stephan Miehlke, Ekkehard Bayerdoerffer, Birgit Wiedemann, David Antos, Anke Sievert, Michael Vieth, Manfred Stolte, Heinrich Schulz
Ahmed Madisch, Stephan Miehlke, Medical Department I, Technical University Hospital, Dresden, Germany
Ekkehard Bayerdoerffer, Department of Hematology and Oncology, University Hospital Marburg, Germany
Birgit Wiedemann, Institute of Medical Statistics and Biometry, Technical University Hospital, Dresden, Germany
David Antos, Clinic for Pediatric Diseases, Ludwig-Maximilians-University-Hospital Munich, Germany
Heinrich Schulz, Anke Sievert, Gastroenterologist in private practice, Bremen, Germany
Michael Vieth, Institute of Pathology, Otto-von Guericke-University of Magdeburg, Germany
Manfred Stolte, Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
Author contributions: All authors contributed equally to the work.
Correspondence to: Ahmed Madisch, M.D., Medical Department I, Technical University Hospital, Fetscherstr. 74, D-01307 Dresden, Germany.
Telephone: +49-351-458-4702 Fax: +49-351-458-4394
Received: July 28, 2004
Revised: July 31, 2004
Accepted: September 9, 2004
Published online: February 28, 2005

AIM: To report the long-term outcome of patients after complete ablation of non-neoplastic Barrett’s esophagus (BE) with respect to BE relapse and development of intraepithelial neoplasia or esophageal adenocarcinoma.

METHODS: In 70 patients with histologically proven non-neoplastic BE, complete BE ablation was achieved by argon plasma coagulation (APC) and high-dose proton pump inhibitor therapy (120 mg omeprazole daily). Sixty-six patients (94.4%) underwent further surveillance endoscopy. At each surveillance endoscopy four-quadrant biopsies were taken from the neo-squamous epithelium at 2 cm intervals depending on the pre-treatment length of BE mucosa beginning at the neo-Z-line, and from any endoscopically suspicious lesion.

RESULTS: The median follow-up of 66 patients was 51 mo (range 9-85 mo) giving a total of 280.5 patient years. A mean of 6 biopsies were taken during surveillance endoscopies. In 13 patients (19.7%) tongues or islands suspicious for BE were found during endoscopy. In 8 of these patients (12.1%) non-neoplastic BE relapse was confirmed histologically giving a histological relapse rate of 3% per year. In none of the patients, intraepithelial neoplasia nor an esophageal adenocarcinoma was detected. Logistic regression analysis identified endoscopic detection of islands or tongues as the only positive predictor of BE relapse (P = 0.0004).

CONCLUSION: The long-term relapse rate of non-neoplastic BE following complete ablation with high-power APC is low (3% per year).

Keywords: Barrett’s esophagus, Argon plasma coagulation, Esophageal adenocarcinoma