Eletrocauterização bipolar da mucosa de Barret apos cirurgia anti-refluxo

AUTOR(ES)
DATA DE PUBLICAÇÃO

1999

RESUMO

Background: The management of Barretl s esophagus requires reduction of gastric acid secretion and screening for the development of adenocarcinoma. However, the current therapeutic options are inneffective in reducing the Barrett s mucosa. The aim of this study was to evaluate the effectiveness of endoscopic thermal coagulation of the Barretl s mucosa as an alternative therapeutic approach, and the recurrence of the disease in the long-term. Methods: Fourteen patients (11M:3F, mean age 45.7 years) with Barretl s .esophagus participated in the study. They were subjected to laparoscopic fundoplication for.the treatment ofreflux, being symptom-free and with no defective fundoplication wraps prior to beginning therapeutic endoscopy. Endoscopic thermocoagulation was performed using a flexible videoendoscope and a BICAP probe. Mucosal areas were treated once monthly until the Barretl s mucosa disappeared. Endoscopy was performed one and seven months folIowing completion of the treatment and once a year thereafter. Results: Mean folIow-~p was 21.6 months (range 18-30 months). The mean length of Barretl s esophagus was 4.8 cm. Successful ablation ofthe columnar epithelium was achieved in 3.7 sessions, as defmed by the demonstration of normal squamous epithelium on histological examination of samples colIected folIowing completion ofthe treatment1md on folIow-up. Three patients experienced short term (10 days) odynophagia/dysphagia. AlI patients remained symptom-free with no evidence of Barrett s esophagus at the end of the study. Conclusions: Bipolar electrocoagulation folIowing antireflux surgery is effective in promoting regression of Barretl s esophagus, with few complications. Endoscopic thermal coagulation might reduce the risks for adenocarcinoma in these patients

ASSUNTO(S)

endoscopia esofago

ACESSO AO ARTIGO

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