Resection and advancement of esophageal mucosa. A potential therapy for Barrett's esophagus

Surgical Endoscopy
T M FarrellJ G Hunter

Abstract

Barrett's esophagus affects 5-10% of patients with gastroesophageal reflux disease (GERD) and is associated with a 40-fold increased risk of malignant transformation. Ablative therapies may lead to esophageal perforation or stricture formation if applied too liberally and residual glandular tissue and persistent cancer risk if utilized too sparingly. Ten pigs underwent gastrotomy. Mucosa below the gastroesophageal (GE) junction was elevated by saline injections, circumferentially incised, and secured to an orogastric tube. By traction, the distal esophageal mucosa was inverted 10 cm proximally, then returned to the gastric lumen. In group A (n = 4), the mucosa (5 cm) was resected and the remnant was allowed to retract. In group B (n = 4), the mucosa was simply sutured back into its native position. In group C (n = 2), the mucosa (5 cm) was resected and the proximal segment was advanced and sutured to the gastric mucosa. At 6 weeks, or sooner if stricture developed, the animals were killed. Stricture formation was determined by ex vivo barium esophagram and gross assessment. The extent of fibrosis and epithelial healing were established histologically. Group A (mucosa resected) developed weight loss and anorexia within 4 weeks. ...Continue Reading

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Citations

Mar 16, 2004·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Gregory G Ginsberg
Oct 13, 2006·Current Opinion in Gastroenterology·Drew B Schembre
Mar 31, 2015·Tissue Engineering. Part B, Reviews·Ricardo Londono, Stephen F Badylak
Jul 29, 2008·Best Practice & Research. Clinical Gastroenterology·Gregory G Ginsberg
Jan 22, 2010·The Cochrane Database of Systematic Reviews·Jonathan Re ReesRebecca C Fitzgerald

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