PMID- 9824599
OWN - NLM
STAT- MEDLINE
DCOM- 19990126
LR  - 20190501
IS  - 0017-5749 (Print)
IS  - 1458-3288 (Electronic)
IS  - 0017-5749 (Linking)
VI  - 43
IP  - 6
DP  - 1998 Dec
TI  - Eradication of Barrett's mucosa with argon plasma coagulation and acid 
      suppression: immediate and mid term results.
PG  - 747-51
AB  - BACKGROUND: Intestinal metaplastic mucosa in Barrett's oesophagus can be replaced 
      by squamous epithelium after mucosal thermal ablation associated with acid 
      suppression therapy. AIMS: To assess whether restoration of squamous epithelium 
      can be obtained after ablation of Barrett's oesophagus using argon plasma 
      coagulation (APC) associated with proton pump inhibitor (PPI) therapy. METHODS: 
      Thirty one patients with Barrett's oesophagus received APC. Omeprazole (40 
      mg/day) was given from the first APC application to one month after completion of 
      the treatment, then given symptomatically. Twenty four hour pH-metry was 
      performed during endotherapy. RESULTS: Complete re-epithelialisation was 
      visualised at endoscopy in 25/31 patients (81%) after a mean number of 2.4 APC 
      sessions (range 1-4). Only partial squamous re-epithelialisation was observed in 
      three patients and three others had no eradication. At histological assessment, 
      eradication of Barrett's oesophagus was only confirmed in 19/31 patients (61%) 
      due to the presence of a few residual Barrett's glands under the new squamous 
      epithelium. Complete eradication was related to a Barrett's oesophagus segment 
      length of less than 4 cm and the absence of circumferential extension but not to 
      the normalisation of oesophageal acid exposure under PPI therapy. Seventeen 
      patients with apparently complete endoscopic and histological eradication of 
      Barrett's oesophagus were re-evaluated at one year; eight (47%) disclosed 
      relapsing islands of Barrett metaplasia despite continuous omeprazole therapy 
      (10-40 mg/day). CONCLUSIONS: APC combined with 40 mg omeprazole daily can 
      eradicate Barrett's mucosa with apparent squamous re-epithelialisation in the 
      majority of patients even in the absence of normalisation of oesophageal acid 
      exposure. However, one year after endotherapy for Barrett's oesophagus, relapse 
      is frequent but limited in extent.
FAU - Van Laethem, J L
AU  - Van Laethem JL
AD  - Department of Gastroenterology, Erasme University Hospital, Brussels, Belgium.
FAU - Cremer, M
AU  - Cremer M
FAU - Peny, M O
AU  - Peny MO
FAU - Delhaye, M
AU  - Delhaye M
FAU - Deviere, J
AU  - Deviere J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Gut
JT  - Gut
JID - 2985108R
RN  - 0 (Antacids)
RN  - 0 (Anti-Ulcer Agents)
RN  - 67XQY1V3KH (Argon)
RN  - KG60484QX9 (Omeprazole)
SB  - IM
CIN - Gut. 1998 Dec;43(6):737-8. PMID: 9824593
MH  - Adult
MH  - Antacids/therapeutic use
MH  - Anti-Ulcer Agents/*therapeutic use
MH  - Argon/therapeutic use
MH  - Barrett Esophagus/*surgery
MH  - Combined Modality Therapy
MH  - Electrocoagulation/*methods
MH  - Endoscopes
MH  - Endoscopy/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hydrogen-Ion Concentration
MH  - Intestinal Mucosa/pathology
MH  - Male
MH  - Metaplasia
MH  - Middle Aged
MH  - Omeprazole/*therapeutic use
MH  - Recurrence
MH  - Treatment Outcome
PMC - PMC1727342
EDAT- 1998/11/21 00:00
MHDA- 1998/11/21 00:01
PMCR- 2001/12/01
CRDT- 1998/11/21 00:00
PHST- 1998/11/21 00:00 [pubmed]
PHST- 1998/11/21 00:01 [medline]
PHST- 1998/11/21 00:00 [entrez]
PHST- 2001/12/01 00:00 [pmc-release]
AID - 10.1136/gut.43.6.747 [doi]
PST - ppublish
SO  - Gut. 1998 Dec;43(6):747-51. doi: 10.1136/gut.43.6.747.