射频消融治疗发育不良的Barrett食管:单中心登记的结果。

IF 2.5 3区 医学 Q1 SURGERY Scandinavian Journal of Surgery Pub Date : 2023-06-01 DOI:10.1177/14574969231151378
Molly Mathiesen, Jakob Holm, Morten Thorsteinsson
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引用次数: 0

摘要

背景和目的:巴雷特食管(BE)与食管腺癌风险增加相关。在多中心试验中,使用射频消融(RFA)完全根除确诊为低级别发育不良(LGD)或高级别发育不良(HGD)的BE是有希望的。我们的目的是在单中心环境中评估与BE和LGD/HGD患者RFA相关的安全性和有效性结果。方法:这是一项在丹麦Rigshospitalet外科和移植科进行的回顾性单中心研究。数据收集自2014年1月至2018年12月期间接受RFA治疗LGD或HGD的所有患者。疗效结果基于组织学:完全根除非典型增生(CE-D),定义为在最后一次活检时所有食管活检均为阴性;完全根除肠化生(CE-IM),定义为食管活检无肠化生。安全性结果基于RFA治疗并发症的比例。结果:随访期间共发现107例患者(75%为男性,中位年龄= 65岁);83%为LGD, 17%为HGD。中位随访时间为25个月。最后一次RFA治疗后,CE-D达到89%。CE-D和CE-IM达到60%。6.5%的患者出现并发症。结论:在BE和确诊的LGD或HGD患者中,RFA与高CE-D率和低并发症风险相关。观察到的安全性和有效性结果与先前在多中心试验中报道的结果相当,表明丹麦治疗合并LGD和HGD的BE与较大的欧洲专家中心相当。
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Radio frequency ablation of dysplastic Barrett's esophagus: Outcomes of a single-center registry.

Background and objective: Barrett's esophagus (BE) is associated with an increased risk of esophageal adenocarcinoma. The use of radio frequency ablation (RFA) for complete eradication of BE with confirmed low-grade dysplasia (LGD) or high-grade dysplasia (HGD) has been promising in multicenter trials. Our aim was to evaluate the safety and efficacy outcomes associated with RFA for patients with BE and LGD/HGD in a single-center setting.

Methods: This was a retrospective single-center study conducted at Department of Surgery and Transplantation, Rigshospitalet, Denmark. Data were collected from all patients who had undergone RFA for LGD or HGD from January 2014 to December 2018. Effectiveness outcomes were based on histology: complete eradication of dysplasia (CE-D), defined as all esophageal biopsies being negative for dysplasia at the last biopsy session, and complete eradication of intestinal metaplasia (CE-IM) defined as esophageal biopsies being without intestinal metaplasia. Safety outcomes were based on the proportion of complications to the RFA treatment.

Results: A total of 107 patients were identified during the follow-up period (75% men, median age = 65 years); 83% had LGD and 17% had HGD. The median follow-up was 25 months. After the last RFA treatment, CE-D was achieved in 89%. CE-D and CE-IM were achieved in 60%. Complications occurred in 6.5% of the patients.

Conclusions: In patients with BE and confirmed LGD or HGD, RFA was associated with a high rate of CE-D and a low risk of complications. The observed safety and efficacy outcomes were comparable with those previously reported in multicenter trials, showing that the Danish treatment of BE with LGD and HGD is comparable with those of larger European expert centers.

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来源期刊
CiteScore
5.50
自引率
4.20%
发文量
37
审稿时长
6-12 weeks
期刊介绍: The Scandinavian Journal of Surgery (SJS) is the official peer reviewed journal of the Finnish Surgical Society and the Scandinavian Surgical Society. It publishes original and review articles from all surgical fields and specialties to reflect the interests of our diverse and international readership that consists of surgeons from all specialties and continents.
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