Endoscopic eradication therapy for Barrett’s esophagus: Adverse outcomes, patient values, and cost-effectiveness

Techniques in Gastrointestinal Endoscopy Pub Date : 2018-04-01 DOI:10.1016/j.tgie.2018.02.002

Swarup Kumar MD , Prasad G. Iyer MSc

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引用次数: 1

Abstract

Endoscopic therapy for Barrett’s esophagus (BE) aims to replace dysplastic BE epithelium with neosquamous epithelium to prevent and reduce the risk of progression to esophageal adenocarcinoma (EAC) and treat early-stage EAC. Various modalities of endotherapy of dysplastic BE are described. Although endoscopic therapy is safe and effective in treating subjects with intramucosal carcinoma (IMCa), high-grade dysplasia (HGD), and confirmed low-grade dysplasia (LGD), challenges to successful treatment are being recognized. Though adverse outcomes of endotherapy such as bleeding, perforation, pain, and stricture formation are observed, they are not common and can usually be treated medically or endoscopically. Patient values and preferences toward endoscopic therapy and the cost-effectiveness of these endoscopic approaches also have crucial implications for the selection of appropriate treatment and subsequent outcomes in patients with BE.

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内镜根除治疗巴雷特食管:不良后果，患者价值和成本效益

内镜治疗Barrett食管(BE)的目的是用新鳞状上皮代替发育不良的BE上皮，以预防和降低进展为食管腺癌(EAC)的风险，并治疗早期EAC。各种形式的内治疗的发育不良BE描述。尽管内镜治疗对于粘膜内癌(IMCa)、高级别不典型增生(HGD)和确诊的低级别不典型增生(LGD)是安全有效的，但成功治疗的挑战正在被认识到。虽然观察到内窥镜治疗的不良后果，如出血、穿孔、疼痛和狭窄形成，但它们并不常见，通常可以通过药物或内窥镜治疗。患者对内窥镜治疗的价值和偏好以及这些内窥镜方法的成本效益也对BE患者选择适当的治疗和随后的结果具有至关重要的意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Techniques in Gastrointestinal Endoscopy GASTROENTEROLOGY & HEPATOLOGY-

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期刊介绍： The purpose of each issue of Techniques in Gastrointestinal Endoscopy is to provide a comprehensive, current overview of a clinical condition or surgical procedure in gastrointestinal endoscopy, combining the effectiveness of an atlas with the timeliness of a journal. Each issue places a vigorous emphasis on diagnosis, rationale for and against a procedure, actual technique, management, and prevention of complications. The journal features abundant illustrations, line drawings and color artwork to guide readers through even the most complicated procedure.

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