Abstract:
BACKGROUND:Endoscopic therapies for early neoplasia in Barrett's esophagus may be a viable alternative to esophagectomy. OBJECTIVE:Our purpose was to compare endoscopic therapy and esophagectomy. DESIGN:Retrospective review from a single institution. SETTING:A medium-sized tertiary referral center. PATIENTS AND INTERVENTIONS:All patients with Barrett's esophagus and dysplasia or intramucosal carcinoma treated by photodynamic therapy (PDT), EMR, or argon plasma coagulation (APC) or esophagectomy with curative intent from May 1998 until November 2005. MAIN OUTCOME MEASUREMENTS:Survival, progression to cancer, eradication of dysplasia and Barrett's esophagus, major and minor complications, and costs were compared. RESULTS:Sixty-two patients who underwent endoscopic therapy (2 APC alone, 18 EMR + APC, 20 PDT + APC, and 22 EMR + PDT + APC) and 32 patients who underwent esophagectomy met the inclusion criteria. The 30-day mortality rate included 1 patient in the endotherapy group (2%) and none in the surgical group (P = .49). No deaths from esophageal cancer occurred in either group. Cancer developed in 6% of endotherapy patients and in none in the surgical cohort (P < .05). Major and minor complications occurred in 8% and 31% of endotherapy patients, respectively, and 13% and 63% of surgery patients (P = .50, P < .001). Median cost to date was $40,079 for endotherapy and $66,060 for esophagectomy (P < .001). LIMITATIONS:Retrospective study, relatively short follow-up, small numbers. CONCLUSIONS:Both endotherapy and esophagectomy can effectively treat high-grade dysplasia and intramucosal carcinoma associated with Barrett's esophagus. Endotherapy is associated with a higher risk of tumor progression, although this is uncommon. Esophagectomy incurs higher initial costs and results in more frequent minor complications but is usually curative.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Schembre DB,Huang JL,Lin OS,Cantone N,Low DEdoi
10.1016/j.gie.2007.08.042subject
Has Abstractpub_date
2008-04-01 00:00:00pages
595-601issue
4eissn
0016-5107issn
1097-6779pii
S0016-5107(07)02653-3journal_volume
67pub_type
杂志文章abstract:BACKGROUND AND AIMS:Schatzki rings are found in the distal esophagus, are associated with hiatal hernias, and present with intermittent dysphagia to solid foods. They can be identified by radiology (GI series or barium swallow studies) or endoscopy. Rings are not always visualized during endoscopy in patients in whom t...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2015.10.041
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:In EMR of early gastric cancer (EGC), en bloc resection reduces the risk of residual cancer. Endoscopic submucosal dissection (ESD) now allows en bloc resection of large EGCs. OBJECTIVE:To retrospectively determine whether ESD is more advantageous than EMR for EGCs. DESIGN:EMR (825 lesions, 711 patients) o...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.03.932
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Biopsy specimens obtained from esophageal lesions detected in endoscopic screening with iodine staining have often been diagnosed as high-grade intraepithelial squamous neoplasia (WHO 2000). However, a management strategy for such lesions has not been established. The purpose of this study was to perform EMR...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.09.027
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:18-Fluorodeoxyglucose positron emission tomography (PET) is used clinically to detect recurrent colon cancer after surgical resection, but the sensitivity of PET for premalignant colon lesions and early stage colon cancer is not well defined. METHODS:In a prospective study, 45 patients with a total of 58 co...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)02775-0
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Although early diagnosis of esophageal carcinoma is an important determinant of outcome, early stage carcinomas are rarely detected on routine endoscopic examination. Iodine staining may be useful in the detection of early stage esophageal carcinoma, especially in high-risk populations. In a prior study, 29....
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1067/mge.2001.111387
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Endosonographic evaluation and sampling of right colonic subepithelial lesions is technically difficult. OBJECTIVE:To evaluate the feasibility, safety, and tissue yield of a prototype front-view, forward-array, curved linear array echoendoscope in the evaluation and sampling of right colonic subepithelial l...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.03.1126
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND AND AIMS:Cold snare polypectomy (CSP) and jumbo forceps polypectomy (JFP) have been shown to be effective for removing diminutive colorectal polyps (DCPs) (≤5 mm). However, no study has compared complete resection rates between CSP and JFP for DCPs. The aim of this study was to compare the efficacy and safet...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2019.01.016
更新日期:2019-07-01 00:00:00
abstract::Colonoscopic removal of large, sessile polyps is difficult, but can be successfully carried out by experienced endoscopists. "Piecemeal" resection with an electrocautery snare was performed at our institution in 108 patients with 132 such lesions. The mean size of the unresected polyps was 3.0 cm. Complications occurr...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(92)70421-0
更新日期:1992-05-01 00:00:00
abstract::Small bowel mucosal biopsy specimens were studied in 52 consecutive patients. Twenty-six patients underwent biopsy by a suction capsule and 16 patients by endoscopy using an 8-mm forceps. Additionally, 10 patients were asked to undergo biopsy by both techniques in the same morning. Material was obtained in 81% of atte...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(86)71846-4
更新日期:1986-08-01 00:00:00
abstract:BACKGROUND:An accurate determination of the extent of Barrett's metaplasia is critical to the study of its natural history and response to therapy. Our hypothesis is that area calculations offer advantages over length estimates of Barrett's. METHODS:Changes in both measures and estimates of progression or regression b...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(97)70173-1
更新日期:1997-06-01 00:00:00
abstract:BACKGROUND AND AIMS:Patients with chronic constipation or motility disorders may be referred for rectal suction biopsy (RSB) to rule out Hirschsprung's disease (HD). RSB may not be successful beyond infancy because of the increased thickness of the rectal mucosa. EMR could improve the diagnostic yield for HD when compa...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2017.08.037
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:The systematic use of metal stents to treat biliary obstruction is restricted by high cost compared with plastic stents. The aims of this study were to compare cost and efficacy of plastic stents and metal stents in the treatment of patients with malignant common bile duct strictures and to define factors th...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mge.2003.66
更新日期:2003-02-01 00:00:00
abstract::Twenty patients undergoing clinically indicated elective colonoscopy were prospectively monitored noninvasively for alterations in cardiorespiratory function. Most of the patients were elderly and many had either cardiac or pulmonary disease. All subjects were premedicated with intramuscular meperidine and continuousl...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(89)72764-4
更新日期:1989-05-01 00:00:00
abstract:BACKGROUND:A screening colonoscopy is recommended in first-degree relatives (FDRs) of colorectal cancer patients; few prospective, controlled studies have evaluated colorectal findings in a population-based screening program. OBJECTIVE:To evaluate the prevalence of colorectal neoplasia (adenomas and adenocarcinomas) i...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.12.025
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:The endoscopic landmark used to diagnose Barrett's esophagus differs between Japanese and Western endoscopists. OBJECTIVE:To compare the degree of diagnostic variation in results achieved by Japanese endoscopists when using the palisade vessels as a landmark of the distal esophagus and when using the gastri...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.04.029
更新日期:2006-08-01 00:00:00
abstract::To investigate the value of 50 mg of topical lidocaine spray in upper gastrointestinal endoscopy, a randomized double-blind placebo-controlled study was undertaken with 50 mg of lidocaine spray as the active treatment. All patients were sedated with diazepam after administration of the spray. Included in the study wer...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0016-5107(93)70110-8
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Cholecystectomy is recommended during hospitalizations for acute biliary pancreatitis (ABP). OBJECTIVE:We sought to assess the population-based effectiveness of index cholecystectomy by using nationwide data. DESIGN:Retrospective, cohort study. SETTING:All acute-care hospitals in Canada from 2007 to 2010....
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2011.08.028
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:The effect of colon preparation quality on adenoma detection rates (ADRs) is unclear, partly because of lack of uniform colon preparation ratings in prior studies. The New Hampshire Colonoscopy Registry collects detailed data from colonoscopies statewide, by using a uniform preparation quality scale after th...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.03.021
更新日期:2014-09-01 00:00:00
abstract::Disposable plastic biopsy forceps were compared prospectively to reusable stainless steel forceps. Thirty consecutive patients underwent a total of 249 biopsies, 124 with the disposable forceps, and 125 with reusable forceps. Biopsy locations included the esophagus, stomach, small intestine, colon, and common bile duc...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/s0016-5107(90)71069-3
更新日期:1990-07-01 00:00:00
abstract:BACKGROUND:Ileoscopy is the criterion standard for mucosal lesions of terminal ileum but is performed in 5% of colonoscopy activity, and the need for training is undefined. OBJECTIVE:To assess the learning curve and skill-keeping line of ileoscopy. DESIGN:Prospective randomized study. SETTING:Single GI endoscopy uni...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2005.09.029
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND AND AIMS:Postpolypectomy bleeding (PPB) is the most common adverse event after colorectal polypectomy. Use of anticoagulants is an important risk factor for PPB. This study aimed to evaluate PPB in patients receiving treatment with warfarin and direct oral anticoagulants (DOACs). METHODS:Between August 2017...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2020.09.046
更新日期:2020-10-03 00:00:00
abstract:BACKGROUND AND AIMS:Hepatic venous pressure gradient (HVPG) currently serves as a surrogate for portal pressure measurement but has many limitations. We developed a novel technique for rapid and direct portal pressure measurements using a digital pressure wire delivered through an EUS-guided 22-gauge FNA needle. Our ai...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2015.11.038
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Better understanding of the pathophysiological mechanisms involved in severe dysmotility disorders is crucial to improve patient management and identify novel therapeutic targets. Recent studies suggested that endoscopic full-thickness biopsies (eFTBs) could be developed as an alternative to surgical biopsie...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2011.01.041
更新日期:2011-05-01 00:00:00
abstract::A new fiberoptic sigmoidoscopic system has been developed that utilizes a disposable sheath to cover and protect all working surfaces of the endoscope from contamination. The reusable part of the endoscope has no air, water, or suction/biopsy channels. These are incorporated in the disposable sheath, which is easily r...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0016-5107(95)70192-3
更新日期:1995-06-01 00:00:00
abstract::The feasibility of infrared video imaging of subsurface vessels in the stomach was investigated both experimentally and in more detail using computer simulations of light propagation. Infrared video imaging was first attempted in several experimental situations. Images of a human arm illuminated with infrared light (w...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(95)70341-1
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:Transgastric flexible endoscopic anastomosis might offer advantages over open and laparoscopic surgery, especially for bariatrics or patients with obstructive malignancy. OBJECTIVE:To develop methods for performing transgastric anastomosis. DESIGN/RESULTS:Twelve gastrojejunal anastomoses were formed in pig...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.09.035
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Hands-on endoscopy workshops are popular and valuable sources for the continuing medical education of endoscopists. Concerns, however, exist regarding clinical outcomes of procedures performed during hands-on training of ERCP. OBJECTIVE:We compared the success rates and complications between patients in the...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2008.05.029
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:The role of Helicobacter pylori in patients with cirrhosis and increased prevalence of peptic ulcers is still poorly defined. The objective is to evaluate the effect of H pylori eradication on ulcer recurrence in patients with cirrhosis. METHODS:The study was conducted at a single, tertiary, referral hospit...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(05)01633-0
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Mechanical lithotripsy has become a well-accepted method of bile duct stone fragmentation and removal. The Olympus lithotripter (Olympus American, Melville, NY) is the standard reusable lithotripter at the institutions that participated in this study. A disposable device with a preassembled pistol grip may p...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/s0016-5107(99)70488-8
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:Gastric carcinoma is known for its propensity to spread to the peritoneum. This study assessed the value of EUS in the detection of ascites not visible on CT in patients with gastric carcinoma. METHODS:A total of 402 consecutive patients with histopathologically confirmed gastric adenocarcinoma underwent ca...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(03)02873-6
更新日期:2004-04-01 00:00:00