Laparoscopic transgastric esophageal mucosal resection: a treatment option for patients with high-grade dysplasia in Barrett's esophagus

American Journal of Surgery
Constantine T FrantzidesMinh B Luu

Abstract

We present long-term follow-up data on patients with esophageal high-grade dysplasia and/or carcinoma in situ who were treated with laparoscopic transgastric esophageal mucosal resection (LTEMR). Patient demographics, operative outcomes, and follow-up results were tabulated. LTEMR was performed in 11 patients (9 male, 2 female). The median age was 54 (44 to 75) years. The 30-day morbidity or mortality was zero. The median follow-up was 5.2 (2 to 12) years. Upper endoscopy was performed at 3, 6, and 12 month, and yearly thereafter. All patients regenerated squamous epithelium at 6 months. One patient developed a recurrence of Barrett's epithelium 2 years after resection. No recurrences of high-grade dysplasia or carcinoma were observed in any of the patients. Two patients developed an esophageal stricture; both were treated successfully with endoscopic balloon dilation and have suffered no further sequelae. LTEMR is safe and effective alternative method to treat patients with Barrett's esophagus with high-grade dysplasia.

References

Jan 6, 2005·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Constantine T FrantzidesAli Keshavarzian
Jun 3, 2009·Nature Reviews. Gastroenterology & Hepatology·Irving Waxman, Vani J A Konda
Mar 2, 2010·American Journal of Surgery·Constantine T FrantzidesJacob E Roberts
Jul 29, 2011·Scandinavian Journal of Gastroenterology·Frederik Hvid-JensenPeter Funch-Jensen

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