Authors: Junichi Akiyama Samuel N Marcus George Triadafilopoulos
Publish Date: 2012/08/10
Volume: 57, Issue: 10, Pages: 2625-2632
Abstract
Endoscopic radiofrequency ablation RFA is a promising new treatment of Barrett’s esophagus BE Adjunctive intraesophageal pH control with proton pump inhibitors and/or antireflux surgery is generally recommended to optimize squamous reepithelialization after ablationOf 45 patients 33 men mean age 616 mean BE length C41 M46 examined for EAE 29 exhibited moderate–severe EAE despite therapy Reduction in BE surface area and CE rate were higher in the normalmild EAE group compared with the moderate–severe EAE group 99 vs 95 p = 002 44 vs 15 p = 009 respectively Using univariate analysis age gender race aspirin/NSAIDs use baseline worst histology baseline BE surface area and the number or types of RFA had no correlation with CE By multivariate multiple logistic regression analysis normalmild EAE and smaller hiatal hernia were independent factors associated with CEEffective intraesophageal pH control is associated with improved RFA outcomes of BE Normal to mild EAE and smaller hiatal hernia are predictive factors to achieve CE Given the frequent persistence of acid reflux despite therapy in BE patients in order to maximize the RFA effects esophageal pH optimization and hernia repair should be considered
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