Effective and safe endoscopic reversal of nondysplastic Barrett’s esophagus with thermal electrocoagulation combined with high-dose acid inhibition: A multicenter study

Richard E. Sampliner, Douglas Faigel, M. Brian Fennerty, David Lieberman, Andrew Ippoliti, Klaus Lewin, Wilfred M. Weinstein

Research output: Contribution to journalArticle

108 Scopus citations

Abstract

Background: Barrett’s esophagus is a metaplastic change in the esophageal lining with an increased risk for adenocarcinoma. Multiple endoscopic techniques have been applied in an effort to reverse Barrett’s. This is a multicenter trial defining the efficacy and safety of multipolar electrocoagulation combined with high-dose acid inhibition. Methods: Patients with a 2-to 6-cm segment of Barrett’s esophagus without dysplasia were enrolled at 3 centers. They were treated with omeprazole 40 mg twice daily and then with up to 6 sessions with electrocoagulation aimed at eliminating all the endoscopically apparent Barrett’s. Four quadrant large-capacity biopsies every 2 cm were centrally assessed for residual intestinal metaplasia. Results: Fifty-eight patients reached the endpoint of failure of visual reversal of Barrett’s after 6 treatment sessions or a 6-month follow-up after the last session. Eighty-five percent had visual reversal and 78% both visual and histologic reversal. Four patients had histologic evidence of residual intestinal metaplasia. Transient esophageal symptoms were common. One patient developed a stricture requiring dilation and one required overnight hospitalization for chest pain. Conclusions: The majority of patients with 2 to 6 cm of nondysplastic Barrett’s esophagus can be safely reversed with this combination therapy. Long-term follow-up will be necessary to document the durability of the new squamous epithelium. (Gastrointest Endosc 2001;53:554-8.).

Original languageEnglish (US)
Pages (from-to)554-558
Number of pages5
JournalGastrointestinal endoscopy
Volume53
Issue number6
DOIs
StatePublished - May 2001

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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