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Sixteen-year follow-up of Barrett's esophagus, endoscopically treated with argon plasma coagulation.
[esophageal adenocarcinoma]
The
thermal
destruction
of
non-
dysplastic
Barrett
's
esophagus
(
BE
)
and
its
replacement
by
squamous
epithelium
is
an
attractive
,
but
unproven
strategy
to
avoid
further
development
of
dysplasia
or
cancer
.
The
goal
of
this
study
was
to
estimate
the
persistence
of
restoration
of
squamous
epithelium
and
the
risk
of
cancer
in
BE
that
was
eradicated
using
argon
plasma
coagulation
(
APC
)
in
the
absence
of
high
-grade
dysplasia
,
16
years
after
its
application
.
We
followed
32
patients
with
BE
who
underwent
eradication
of
metaplastic
epithelium
using
APC
,
up
to
16
years
later
.
At
the
end
of
the
initial
treatment
,
25
of
32
patients
(
78
%
)
had
complete
endoscopic
eradication
,
there
was
partial
squamous
re
-epithelialization
in
four
patients
(
13
%
)
and
it
was
absent
in
three
patients
(
9
%
)
.
We
observed
buried
metaplastic
glands
under
new
squamous
epithelium
in
6
of
the
25
patients
who
had
complete
endoscopic
eradication
.
At
follow-up
,
sustained
complete
endoscopic
eradication
was
observed
in
16
of
32
patients
(
50
%
)
,
partial
eradication
in
11
of
32
patients
(
35
%
)
;
there
were
two
patients
(
6
%
)
lost
to
follow-up
and
three
patients
(
9
%
)
developed
esophageal
adenocarcinoma
.
Two
of
the
latest
cases
arose
from
the
buried
glands
under
neosquamous
epithelium
after
complete
eradication
and
one
arose
from
a
small
remaining
Barrett
's
segment
.
We
observed
long
-term
re
-epithelialization
in
the
majority
of
patients
who
had
previously
had
complete
eradication
of
Barrett
's
esophagus
.
This
did
not
provide
protection
against
cancer
development
,
as
the
incidence
of
cancers
arising
from
buried
glands
or
from
residual
Barrett
's
esophagus
was
similar
to
that
observed
in
patients
undergoing
no
specific
treatment
.
Diseases
Validation
Diseases presenting
"specific treatment"
symptom
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
benign recurrent intrahepatic cholestasis
canavan disease
classical phenylketonuria
cystinuria
esophageal adenocarcinoma
fabry disease
familial hypocalciuric hypercalcemia
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
megacystis-microcolon-intestinal hypoperistalsis syndrome
severe combined immunodeficiency
werner syndrome
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