DEVELOPMENT OF ADENOCARCINOMA AFTER RADIOFREQUENCY ABLATION OF BARRETT’S ESOPHAGUS ASSOCIATED TO FUNDOPLICATION AND SUPPRESSION-DUODENAL DIVERSION PROCEDURE: A LESSON TO BE LEARNED

Braghetto, Italo

doi:10.1590/0102-672020230068e1786

Brasil

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Letter to the Editor • ABCD, arq. bras. cir. dig. 36 • 2023 • https://doi.org/10.1590/0102-672020230068e1786 linkcopy

DEVELOPMENT OF ADENOCARCINOMA AFTER RADIOFREQUENCY ABLATION OF BARRETT’S ESOPHAGUS ASSOCIATED TO FUNDOPLICATION AND SUPPRESSION-DUODENAL DIVERSION PROCEDURE: A LESSON TO BE LEARNED

ADENOCARCINOMA EM ESÔFAGO DE BARRETT APÓS ABLAÇÃO POR RADIOFREQUÊNCIA ASSOCIADA A FUNDOPLICATURA E DIVERSÃO DUODENAL

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Despite endoscopic eradication therapy being an effective and durable treatment for Barrett’s esophagus-related neoplasia, even after achieving initial successful eradication, these patients remain at risk of recurrence and require ongoing routine examinations. Failure of radiofrequency ablation and argon plasma coagulation is reported in 10–20% of cases.

HEADGINGS: Barrett Esophagus; Endoscopy; Radiofrequency Ablation; Argon Plasma Coagulation; Fundoplication; Gastrectomy

			APC	RFA	p-value
			n=21 (%)	n=31 (%)	p-value
Intestinal metaplasia
	Before treatment		20 (95.2)	25(80.6)	<0.21
	After treatment
		Total initial eradication	14 (66.6)^* * Eradication with regression to carditis	17 (54.8)^* * Eradication with regression to carditis	<0.02
		Residual island	6 (28.6)^† † Treated with repeated APC	8 (25.8)^† † Treated with repeated APC	<0.02
		Reappearance during follow-up	1 (5)^† † Treated with repeated APC	4 (12.9)^† † Treated with repeated APC	>0.37
		Progression to LGD	0	0
Intestinal metaplasia with LGD
	Before treatment		1 (4.8)	6 (19.4)	>0.21
	After treatment
		Total initial eradication	1 (100)^* * Eradication with regression to carditis	4 (66.6)^* * Eradication with regression to carditis	>0.37
		Residual island of IM	0	2^‡ ‡ Submitted to endoscopic submucosal dissection.	1.0
		Reappearance IM during follow-up	1^† † Treated with repeated APC	1^† † Treated with repeated APC	>0.4
		Reappearance LGD during follow-up	0	0
		Progression to HGD during follow-up	0	0
		Progression to adenocarcinoma	0	1^§ § Submitted to esophageal resection.

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Colégio Brasileiro de Cirurgia Digestiva Av. Brigadeiro Luiz Antonio, 278 - 6° - Salas 10 e 11, 01318-901 São Paulo/SP Brasil, Tel.: (11) 3288-8174/3289-0741 - São Paulo - SP - Brazil
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Acessibilidade / Reportar erro

[TFN1] ^*
Eradication with regression to carditis

[TFN2] ^†
Treated with repeated APC

[TFN3] ^‡
Submitted to endoscopic submucosal dissection.

[TFN4] ^§
Submitted to esophageal resection.

[TFN5] APC: argon plasma coagulation; RFA: radiofrequency ablation; LGD: low-grade dysplasia; IM: intestinal metaplasia; HGD: high-grade dysplasia.