Abstract
Background: Endoscopic treatment of Barrett's oesophagus leading to high grade dysplasia with oesophageal varices may lead to bleeding complications. Aims: Estimate effectiveness of endoscopic band-ligation in oesophageal varices patients treated for high grade dysplasia, and compare to endoscopically treated non-oesophageal varices high grade dysplasia patients. Methods: Retrospective comparative study. All 8 high grade dysplasia patients with varices who were treated initially with band-ligation at Mayo Clinic between 8/1/1999 and 2/28/2014 were compared with reference group of 52 high grade dysplasia patients treated endoscopically. Results: One high grade dysplasia patients patient with oesophageal varices (12.5%) achieved complete remission of intestinal metaplasia defined by at least one followup endoscopy with normal biopsies, and 3 (37.5%) achieved complete remission of dysplasia defined by at least one followup endoscopy with non-dysplastic biopsies. 39 (75.0%) endomucosal resection/radiofrequency ablation patients experienced at least one followup endoscopy with normal biopsies, and 49 (94.2%) experienced non-dysplastic biopsies. Both of these endpoints occurred significantly more often in the endomucosal resection/radiofrequency ablation group compared to the high grade dysplasia with oesophageal varices group (p = 0.016 and p = 0.025, respectively). Conclusions: High grade dysplastic Barrett's can be safely managed with band-ligation. However, resolution of Barrett's epithelium is rarely achieved with banding alone.
Original language | English (US) |
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Pages (from-to) | 763-768 |
Number of pages | 6 |
Journal | Digestive and Liver Disease |
Volume | 47 |
Issue number | 9 |
DOIs | |
State | Published - Sep 1 2015 |
Keywords
- Barrett's oesophagus
- Cirrhosis
- Dysplasia
- Endomucosal resection
- Endoscopic ultrasonography (EUS)
- Eradication
- Oesophageal cancer
- Portal hypertension
ASJC Scopus subject areas
- Hepatology
- Gastroenterology