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Endoscopic Resections for Barrett's Neoplasia: A Long-Term, Single-Center Follow-Up Study.
Löfdahl, Per; Edebo, Anders; Wolving, Mats; Bratlie, Svein Olav.
Afiliación
  • Löfdahl P; Department of Surgery, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
  • Edebo A; Department of Surgery, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
  • Wolving M; Department of Pathology, Sahlgrenska University Hospital, 413 46 Göteborg, Sweden.
  • Bratlie SO; Department of Surgery, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
Medicina (Kaunas) ; 60(7)2024 Jun 30.
Article en En | MEDLINE | ID: mdl-39064503
ABSTRACT
Background and

Objectives:

Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are both well-established and effective treatments for dysplasia and early cancer in Barrett's esophagus (BE). This study aims to compare the short- and long-term outcomes associated with these procedures in treating Barrett's neoplasia. Materials and

Methods:

This single-center retrospective cohort study included 95 patients, either EMR (n = 67) or ESD (n = 28), treated for Barrett's neoplasia at Sahlgrenska University Hospital between 2004 and 2019. The primary outcome was the complete (en-bloc) R0 resection rate. Secondary outcomes included the curative resection rate, additional endoscopic resections, adverse events, and overall survival.

Results:

The complete R0 resection rate was 62.5% for ESD compared to 16% for EMR (p < 0.001). The curative resection rate for ESD was 54% versus 16% for EMR (p < 0.001). During the follow-up, 22 out of 50 patients in the EMR group required additional endoscopic resections (AERs) compared to 3 out of 21 patients in the ESD group (p = 0.028). There were few adverse events associated with both EMR and ESD. In both the stratified Kaplan-Meier survival analysis (Log-rank test, Chi-square = 2.190, df = 1, p = 0.139) and the multivariate Cox proportional hazards model (hazard ratio of 0.988; 95% CI 0.459 to 2.127; p = 0.975), the treatment group (EMR vs. ESD) did not significantly impact the survival outcomes.

Conclusions:

Both EMR and ESD are effective and safe treatments for BE neoplasia with few adverse events. ESD resulted in higher curative resection rates with fewer AERs, indicating its potential as a primary treatment modality. However, the survival analysis showed no difference between the methods, highlighting their comparable long-term outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Esófago de Barrett / Resección Endoscópica de la Mucosa Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Medicina (Kaunas) Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Esófago de Barrett / Resección Endoscópica de la Mucosa Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Medicina (Kaunas) Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Suiza