Efficacy and Durability of Cryospray Ablation for Dysplastic BarrettÃ¢ÂÂs EsophagusJayaprakash Sreenarasimhaiah*
Department of Medicine, University of Texas Southwestern Medical Center, USA
- *Corresponding Author:
- Jayaprakash Sreenarasimhaiah
Department of Medicine Division of Digestive and Liver Disease
University of Texas Southwestern Medical Center 5323 Harry Hines Blvd
MC 90 Dallas, TX 75390, USA
Received date: August 21, 2014; Accepted date: September 15, 2014; Published date: September 20, 2014
Citation: Sreenarasimhaiah J (2014) Efficacy and Durability of Cryospray Ablation for Dysplastic Barrett’s Esophagus. J Gastroint Dig Syst 4:220. doi:10.4172/2161-069X.1000220
Copyright: © 2014 Sreenarasimhaiah J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Dysplastic Barrett's esophagus is the precursor to esophageal adenocarcinoma. While traditional therapy has included surgical resection, several endoscopic ablation techniques have become well-established. The newest of these modalities is cryospray ablation using liquid nitrogen. Objective: To determine efficacy of cryospray ablation therapy in eradication of Barrett's mucosa and dysplastic tissue as well as the durability of these outcomes. Methods: A retrospective analysis of 33 consecutive patients who underwent endoscopic cryoablation therapy was performed. Patients were followed at 8 weeks, 6 months, and annually following completion of ablation. Biopsies were taken. Results: A mean of 2.4 sessions (range 1-4) was performed with a mean follow-up of 12.5 months (range 6-36). 100% of patients with low-grade dysplasia achieved complete eradication of dysplasia at a minimum follow-up of 6 months. 95% of highgrade dysplasia was eradicated at 6 months with 5% having persistent focal low-grade dysplasia. In 9% of cases, intramucosal carcinoma was also treated successfully with cryospray ablation therapy. Overall stricture rate was 3% following ablation therapy. No perforations or other serious complications occurred Conclusions: Cryoablation therapy offers an effective minimimally-invasive method to treat dysplastic Barrett's esophagus as well as some early intramucosal adenocarcinoma. There is minimal morbidity from this procedure and has potentially durable results at follow-up endoscopic surveillance.