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Barrett'soesophagus: long-term follow-up after complete ablation with argon plasmacoagulation and the factors that determine its recurrence. FERRARIS R., FRACCHIA M., FOTIM., SIDOLI L. ,TARAGLIO S. ,VIGANO' L.,GIACCONE C., REBECCHI F.,MEINERI G., SENORE C.,PERA A., GRUPPO OPERATIVO STUDIO PRECANCEROSIESOFAGEE Alimentary Pharmacology &Therapeutics. 25(7):835-840, April 2007.
Background:Argon plasma coagulation seems to be a promising technique for ablation ofBarrett's oesophagus, yet few long-term efficacy data are available. Aim:To report on a long-term follow-up and the factors that determine therecurrence of intestinal metaplasia in a cohort of patients with nondysplastic, intestinal type Barrett's oesophagus, after complete ablation ofthe metaplastic mucosa with argon plasma coagulation. Methods:Ninety-six patients underwent endoscopic argon plasma coagulation with adequateacid suppression obtained through a continuous omeprazole therapy (50 patients)or through laparoscopic fundoplication (46 patients). Complete ablation wasachieved in 94 patients who underwent follow-up. Endoscopic and histologicalexaminations were performed every 12 months. Results:The median follow-up of the patients was 36 months (range 18-98). A recurrenceof intestinal metaplasia was found in 17 patients (18%), with an annualrecurrence rate of 6.1%. Neither dysplasia, nor adenocarcinoma were foundduring the follow-up. Through the use of logistic regression analysis, previouslaparoscopic fundoplication was associated with a reduced recurrence rate ofintestinal metaplasia (odds ratio 0.30, 95% confidence interval 0.10-0.93). Conclusions:The long-term recurrence of intestinal type Barrett's oesophagus was low aftercomplete ablation with argon plasma coagulation. The control of oesophagealacidity acid exposure with laparoscopic fundoplication seems to reduce therecurrence rate.Leggi l'articolo