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Medicentro Electrónica
versão On-line ISSN 1029-3043
Resumo
MORALES MARTINEZ, Ignacio; BRIZUELA QUINTANILLA, Raúl A; ARMENTEROS TORRES, Mildred Cecilia e DURAN MORERA, Noira. Endoscopic treatment of Barrett's esophagus with low- and high-grade dysplasia. Medicentro Electrónica [online]. 2022, vol.26, n.3, pp. 637-656. Epub 01-Set-2022. ISSN 1029-3043.
Introduction:
Barrett's esophagus is an acquired esophageal condition that can evolve into an adenocarcinoma. Over the years, endoscopic therapy has replaced surgery in the treatment of this condition.
Objectives:
to show the results of the application of the endoscopic mucosal resection and Hybrid-APC ablation technique in patients with Barrett's esophagus with low-grade or high-grade dysplasia.
Methods:
a descriptive and retrospective study was carried out in 29 patients between 2014 and 2019, in the Endoscopy service of the National Center for Minimal Access Surgery. Social and demographic variables were studied; endoscopic classification of Barrett's esophagus was established, as well as the characteristics of the lesion, histological diagnosis, endoscopic therapy, the presence of complications, incomplete resection and recurrence were described. Descriptive statistics techniques and non-parametric methods were applied.
Results:
male gender (58.62%) and the group aged 41-60 years (58.62%) predominated. The short segment with flat lesions and the long segment with raised lesions were more frequent (37.93%). A number of 15 resections and 14 ablations were performed with Hybrid-APC; one stricture was observed as a complication of endoscopic mucosal resection and recurrences with both techniques (5 patients, 17%), three related to resection and two to Hybrid-APC. The Hybrid-APC achieved a therapeutic effectiveness of 85.71% and the resection one of 80%.
Conclusions:
endoscopic treatment with low- and high-grade dysplasia proved to be an effective and safe procedure, with a low percentage of complications and recurrences.
Palavras-chave : Barrett esophagus/surgery; natural orifice endoscopic surgery; argon plasma coagulation.