Treatment of dysplastic Barrett＇s Oesophagus in lowervolume centres after structured training

• 作者: Georgina Chadwick Jack Faulkner Robert Ley-Greaves Panagiotis Vlavianos Rob Goldin Jonathan Hoare
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Barrett's OESOPHAGUS OESOPHAGEAL cancer ENDOSCOPIC TREATMENT Radiofrequency ablation ENDOSCOPIC resection
• 年，卷（期）: 2015,（1）
• 页码范围: 66-72
• 页数: 7页
• 分类号: R

摘要

AIM： To investigate whether dysplastic Barrett＇sOesophagus can be safely and effectively treatedendoscopically in low volume centres after structuredtraining.METHODS： After attending a structured trainingprogram in Amsterdam on the endoscopic treatmentof dysplastic Barrett＇s Oesophagus, treatment ofthese patients was initiated at St Marys Hospital. Thisis a retrospective case series conducted at a UnitedKingdom teaching Hospital, of patients referred forendoscopic treatment of Barrett＇s oesophagus with highgrade dysplasia or early cancer, who were diagnosedbetween January 2008 and February 2012. Datawas collected on treatment provided （radiofrequencyablation and endoscopic resection）, and success oftreatment both at the end of treatment and at followup. Rates of immediate and long term complicationswere assessed.RESULTS： Thirty-two patients were referred to StMarys with high grade dysplasia or intramucosal cancerwithin a segment of Barrett＇s Oesophagus. Twentysevenmet the study inclusion criteria, 16 of these hada visible nodule at initial endoscopy. Treatment wasgiven over a median of 5 mo, and patients receiveda median of 3 treatment sessions over this time.At the end of treatment dysplasia was successfullyeradicated in 96% and intestinal metaplasia in 88%, onper protocol analysis. Patients were followed up for amedian of 18 mo. At which time complete eradicationof dysplasia was maintained in 86%. Complicationswere 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.