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首页> 外文期刊>Endoscopy International Open >Salvage cryotherapy in patients undergoing endoscopic eradication therapy for complicated Barrett’s esophagus
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Salvage cryotherapy in patients undergoing endoscopic eradication therapy for complicated Barrett’s esophagus

机译：内镜根除治疗复杂性巴雷特食管的患者中进行挽救性冷冻治疗

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Background and study aims?Some patients with dysplastic Barrett’s esophagus (BE) experience suboptimal response to radiofrequency ablation (RFA), endoscopic mucosal resection (EMR), or the combination. Cryotherapy has been used as salvage therapy in these patients, but outcomes data are limited. We aimed to assess clinical outcomes among a large cohort of patients with dysplastic BE whose condition had failed to respond to RFA and/or EMR. Patients and methods?This was a retrospective cohort study of consecutive cases of dysplastic BE or intramucosal carcinoma (IMC) treated with salvage cryotherapy at a tertiary-care academic medical center. The primary goal of cryotherapy treatment was eradication of all neoplasia. The secondary goal was eradication of all intestinal metaplasia. The proportion of patients undergoing salvage cryotherapy who achieved complete eradication of dysplasia (CE-D) and metaplasia (CE-IM), as well as the time to CE-D and CE-IM were calculated. Results?Over a 12-year period, 46 patients received salvage cryotherapy. All patients underwent RFA prior to cryotherapy, either at our center or prior to referral, and 50?% of patients underwent EMR. A majority of patients (54?%) had high-grade dysplasia (HGD) at referral, while 33?% had low-grade dysplasia (LGD), and 13?% had IMC. Overall, 38 patients (83?%) reached CE-D and 21 (46?%) reached CE-IM. Median time to CE-D was 18 months, median number of total interventions (RFA, cryotherapy, and EMR) was five, and median number of cryotherapy sessions was two. Conclusion?Salvage cryotherapy appears safe and effective for treating BE that is refractory to RFA and/or EMR.
机译：背景和研究目的？一些患有增生性Barrett食管（BE）的患者对射频消融（RFA），内窥镜黏膜切除术（EMR）或两者结合的治疗效果欠佳。在这些患者中，冷冻疗法已被用作挽救疗法，但结果数据有限。我们的目的是评估一大批病态BE对RFA和/或EMR无效的增生性BE患者的临床结局。患者和方法？这是一项在三级医疗学术医学中心接受挽救性冷冻疗法治疗的增生性BE或粘膜内癌（IMC）连续病例的回顾性队列研究。冷冻疗法的主要目标是根除所有肿瘤。次要目标是消除所有肠上皮化生。计算了完全治愈不典型增生（CE-D）和化生（CE-IM）的接受挽救性冷冻疗法的患者的比例，以及达到CE-D和CE-IM的时间。结果：在12年的时间里，有46名患者接受了挽救性冷冻疗法。在我们中心或转诊之前，所有患者均在冷冻治疗之前接受了RFA，并且50％的患者接受了EMR。多数患者（54％）在转诊时患有高度不典型增生（HGD），而33％的患者患有低度不典型增生（LGD），而13％的患者患有IMC。总体而言，有38例（83％）的患者达到了CE-D，有21例（46 %%）达到了CE-IM。接受CE-D治疗的中位时间为18个月，总干预（RFA，冷冻疗法和EMR）的中位数为5，而冷冻疗法疗程的中位数为2。结论：挽救性冷冻疗法对于治疗RFA和/或EMR难治的BE似乎是安全有效的。

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