Endoscopic Therapy for Barrett's Esophagus PDF
Preview Endoscopic Therapy for Barrett's Esophagus
Endoscopic Therapy for Barrett’s Esophagus Edited by Richard E. Sampliner , MD CLINICAL GASTROENTEROLOGY SeriesEditor GeorgeY.Wu UniversityofConnecticutHealthCenter,Farmington,CT,USA Forfurthervolumes: http://www.springer.com/series/7672 Endoscopic Therapy for Barrett’s Esophagus Edited by R E. S ICHARD AMPLINER, MD University of Arizona College of Medicine, USA Editor RichardE.Sampliner CollegeofMedicine UniversityofArizona P.O.Box245028 TucsonAZ85724-5028 AHSC6406 USA [email protected] [email protected] ISBN978-1-60327-444-9 e-ISBN978-1-60327-445-6 DOI10.1007/978-1-60327-445-6 SpringerDordrechtHeidelbergLondonNewYork LibraryofCongressControlNumber:2009929319 (cid:2)C HumanaPress,apartofSpringerScience+BusinessMedia,LLC2009 Allrightsreserved.Thisworkmaynotbetranslatedorcopiedinwholeorinpartwithoutthewrit- tenpermissionofthepublisher(HumanaPress,c/oSpringerScience+BusinessMedia,LLC,233 SpringStreet,NewYork,NY10013,USA),exceptforbriefexcerptsinconnectionwithreviewsor scholarlyanalysis.Useinconnectionwithanyformofinformationstorageandretrieval,electronic adaptation,computersoftware,orbysimilarordissimilarmethodologynowknownorhereafter developedisforbidden. Theuseinthispublicationoftradenames,trademarks,servicemarks,andsimilarterms,evenif theyarenotidentifiedassuch,isnottobetakenasanexpressionofopinionastowhetherornot theyaresubjecttoproprietaryrights. Whiletheadviceandinformationinthisbookarebelievedtobetrueandaccurateatthedateof goingtopress,neithertheauthorsnortheeditorsnorthepublishercanacceptanylegalresponsi- bilityforanyerrorsoromissionsthatmaybemade.Thepublishermakesnowarranty,expressor implied,withrespecttothematerialcontainedherein. Printedonacid-freepaper SpringerispartofSpringerScience+BusinessMedia(www.springer.com) Preface EndoscopictherapyforBarrett’sesophagus(BE)hascomeofage.This is documented by the publication of a randomized controlled trial of one modality and an abstract of a randomized sham-controlled trial of another. The goal of this book is to highlight and detail the differing techniques of ablation for the elimination of neoplasia and intestinal metaplasiainBE.Theauthorsareallexpertsintheutilizationofendo- scopic therapy for BE. The latest developments in technology and the mostrecentclinicaldataarereviewed. Additionalchaptersonendoscopicimagingmodalitiestodetectdys- plasia, decision making in the clinical arena, and cost-effectiveness of ablationroundoutthisapproachtothemanagementofBE. High-grade dysplasia and early (intramucosal) adenocarcinoma should not lead to automatic esophagectomy in the current era. Famil- iarity with the availability of ablation techniques is essential for every cliniciandealingwithpatientswithBarrett’sesophagus. RichardE.Sampliner,MD v Contents Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix NewTechnologiesforImagingofBarrett’sEsophagus . . . . . . . 1 HerbertC.WolfsenandMichaelB.Wallace ArgonPlasmaCoagulationinBarrett’sEsophagus:The MostWidelyAvailableTechnique . . . . . . . . . . . . . . . . . 21 StephenE.AttwoodandSuvadipChatterjee Radiofrequency Ablation for Eradication of Barrett’s Esophagus:ADescriptionoftheEndoscopicTechnique, ItsClinicalResults,andFutureProspects . . . . . . . . . . . . . 43 RoosE.PouwandJacquesJ.G.H.M.Bergman Decision Making in Ablation: Disease, Patients, andInstitutionalFactors . . . . . . . . . . . . . . . . . . . . . 63 GaryW.Falk MultipolarElectrocoagulation(MPEC):AnEarly,Widely AvailableTechnique . . . . . . . . . . . . . . . . . . . . . . . 91 V.RamanMuthusamyandPrateekSharma EndoscopicMucosalResectioninBarrett’sEsophagus: EndoscopicSurgery . . . . . . . . . . . . . . . . . . . . . . . 107 KennethK.WangandYutakaTomazawa Combination–MultimodalTherapy . . . . . . . . . . . . . . . . 119 OliverPech,HendrikManner,andChristianEll PhotodynamicTherapy(PDT):TheBest-ValidatedTechnique . . . . 131 V.RamanMuthusamyandKennethJ.Chang CryoablationofBarrett’sEsophagus . . . . . . . . . . . . . . . . 155 MichaelJ.KrierandPankajJayPasricha Cost-EffectivenessofEndoscopicTherapyforBarrett’sEsophagus . 165 PatrickYachimskiandChinHur Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187 vii Contributors STEPHEN E. ATTWOOD, MD, FRCSI •DepartmentofSurgery NewcastleUniversity,NewcastleuponTyne,UnitedKingdom JACQUES J.G.H.M. BERGMAN, MD, PHD •Departmentof GastroenterologyandHepatology,AcademicMedicalCenter, Amsterdam,theNetherlands KENNETH J. CHANG, MD •H.H.ChaoComprehensiveDigestive DiseaseCenter,SchoolofMedicine,UniversityofCalifornia,Irvine, Orange,CA SUVADIP CHATTERJEE, MB, MRCP •Departmentof Gastroenterology,NorthTynesideHospital,Northumbria Healthcare,TyneandWear,UnitedKingdom CHRISTIAN ELL, MD •DepartmentofInternalMedicine,HSK Wiesbaden,Wiesbaden,Germany GARY W. FALK, MD, MS •DepartmentofGastroenterologyand Hepatology,ClevelandClinic,Cleveland,OH CHIN HUR, MD, MPH •GastrointestinalUnitandInstitutefor TechnologyAssessment,MassachusettsGeneralHospital,Harvard MedicalSchool,Boston,MA MICHAEL J. KRIER, MD •DivisionofGastroenterology/Hepatology, StanfordUniversitySchoolofMedicine,Stanford,CA HENDRIK MANNER, MD •DepartmentofInternalMedicine,HSK Wiesbaden,Wiesbaden,Germany V. RAMAN MUTHUSAMY, MD •DepartmentofVeteransAffairs MedicalCenter,DivisionofGastroenterology,KansasCity,MO PANKAJ JAY PASRICHA, MD •DivisionofGastroenterology/ Hepatology,StanfordUniversitySchoolofMedicine,Stanford,CA OLIVER PECH, MD •DepartmentofInternalMedicine,HSK Wiesbaden,Wiesbaden,Germany ROOS E. POUW, MD •DepartmentofGastroenterologyand Hepatology,AcademicMedicalCenter,Amsterdam,theNetherlands PRATEEK SHARMA, MD •DepartmentofVeteransAffairsMedical Center,DivisionofGastroenterology,KansasCity,MO YUTAKA TOMAZAWA, MD •ResearchAssociate,Barrett’s EsophagusUnit,MayoClinic,Rochester,MN MICHAEL B. WALLACE, MD, MPH •ProfessorofMedicing,Mayo MedicalSchool,Rochester,MN ix x Contributors KENNETH K. WANG, MD •ProfessorofMedicine,Barrett’s EsophagusUnit,MayoClinic,Rochester,MN HERBERT C. WOLFSEN, MD •Consultant,Divisionof GastroenterologyandHepatology,MayoClinic,Jacksonville,FL; AssociateProfessor,MayoMedicalSchool,Rochester,MN PATRICK YACHIMSKI, MD, MPH •GastrointestinalUnit, MassachusettsGeneralHospital,HarvardMedicalSchool, Boston,MA New Technologies for Imaging of Barrett’s Esophagus Herbert C. Wolfsen, MD and Michael B. Wallace, MD, MPH CONTENTS INTRODUCTION WHITE LIGHT ENDOSCOPIC IMAGING FOR BARRETT’S ESOPHAGUS CHROMOENDOSCOPY AND BARRETT’S ESOPHAGUS NARROW BAND IMAGING AND BARRETT’S ESOPHAGUS AUTO-FLUORESCENCE IMAGING, TRI-MODAL IMAGING, AND BARRETT’S ESOPHAGUS CONFOCAL FLUORESCENT MICROSCOPY AND ENDOCYTOSCOPY FOR BARRETT’S ESOPHAGUS SPECTROSCOPY OPTICAL COHERENCE TOMOGRAPHY (OCT) CONCLUSIONS AND THE FUTURE OF IMAGING FOR BARRETT’S ESOPHAGUS REFERENCES Disclaimers:Therearenoconfictsofinterestrelatingtothispublication. From:ClinicalGastroenterology:EndoscopicTherapyforBarrett’sEsophagus, Editedby:R.E.Sampliner, DOI10.1007/978-1-60327-445-6 1, (cid:2)C HumanaPress,apartofSpringerScience+BusinessMedia,LLC2009 1 2 WolfsenandWallace Summary Several important endoscopic imaging modalities have recently beenapprovedforuseandarecommerciallyavailable.Thischapter briefly reviews these developments and the implication for patients withBarrett’sesophagus,especiallyadvanceddysplasiaandmucosal carcinoma.Importantdevelopmentsinbiophotonicshavebeenmov- ingfromtheexperimentlaboratorytothegastrointestinalendoscopy unit. Narrow band imaging, auto-fluorescence, confocal fluores- cent microscopy, spectroscopy and optical coherence tomography are reviewed. Unresolved issues for most of these technologies includeregulatoryapproval,commercialavailabilityanddemonstra- tion of clinical utility. This chapter reviews recent developments in endoscopy-based imaging modalities in patients with Barrett’s esophagus. Key Words: Narrow band imaging, Auto-fluorescence, Confocal microscopy,Spectroscopy,Opticalcoherencetomography INTRODUCTION Several important endoscopic imaging modalities have recently been approved for use and are commercially available. This chapter briefly reviews these developments and the implications for patients with Barrett’s disease, especially advanced dysplasia and mucosal carci- noma. The history of Barrett’s esophagus features several important milestones.NormanBarrettinitiallydescribedacongenitalshortesoph- aguswithulcerationsinthegastriccardia.Later,othersdeterminedthat Barrett’s esophagus represented acquired glandular ulcerations of the distalesophagus[1,2]relatedtoseveregastroesophagealrefluxdisease [3], with increasing rates of dysplasia and adenocarcinoma [4]. Subse- quently,muchoftheinterestinBarrett’sesophagushasfocusedonthe utility of standard resolution white light surveillance endoscopy, with random mucosal biopsies to detect dysplasia and early carcinoma [5]. Recently, important developments in biophotonics have been moving from the laboratory to the gastrointestinal endoscopy unit. Unresolved issuesformostofthesetechnologiesincluderegulatoryapproval,com- mercial availability, demonstration of clinical utility, securing reim- bursement for the required additional time and imaging equipment, as well clarifying the medical–legal issues associated with image interpretation and data storage. This chapter reviews recent develop- mentsinendoscopy-basedimagingmodalitiesinpatientswithBarrett’s esophagus.
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