Nonthermal resection device for ablation of Barrett’s esophagus: a feasibility and safety study
- 14 September 2021
- journal article
- research article
- Published by Georg Thieme Verlag KG in Endoscopy
- Vol. 54 (06), 545-552
- https://doi.org/10.1055/a-1644-4326
Abstract
Background Several techniques exist for the eradication of Barrett’s esophagus (BE); however, all have limitations regarding successful conversion to squamous epithelium and a complication profile. We aimed to assess the feasibility and safety of a new nonthermal device, the EndoRotor, for the eradication of BE as a first-line ablation technique. Methods Patients with BE were prospectively included at two tertiary referral centers in The Netherlands. Inclusion criteria: BE length 2–5 cm, with low grade dysplasia, high grade dysplasia, or residual BE after endoscopic resection (ER) of a lesion containing early neoplasia. Exclusion criteria: previous ER > 50 % circumference, or previous ablation therapy. Follow-up endoscopy was performed 3 months after ablation therapy. Outcomes were the percentage of endoscopically visible BE surface regression and complications. Results 30 patients were included (age 66 years, interquartile range [IQR] 59–73, median BE C0M3, 25 male). Overall, 18 patients underwent ER prior to ablation. Median percentage BE ablated was 100 % (IQR 94 %–100 %). Median visual BE surface regression at 3-month follow-up was 80 % (IQR 68 %–95 %). Multiple residual Barrett’s islands were commonly seen. Six patients (20 %) had a treatment-related complication requiring intervention, including one perforation (3 %), one postprocedural hemorrhage (3 %), and four strictures (13 %). Post-procedural pain was reported in 18 patients (60 %). Conclusions Endoscopic ablation of BE using this novel nonthermal device was found to be technically demanding, with a longer procedure time compared with established ablation techniques and a high complication rate. Based on these results, we do not recommend its use as a first-line ablation technique for the eradication of BE. * Co-first authors Received: 06 February 2021 Accepted after revision: 14 September 2021 Accepted Manuscript online: 14 September 2021 Article published online: 21 December 2021 © 2021. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyFunding Information
- Interscope Inc., Northbridge, MA, USA
This publication has 32 references indexed in Scilit:
- Role of Acid Suppression in the Development and Progression of Dysplasia in Patients with Barrett’s EsophagusDigestive Diseases, 2011
- Safety and efficacy of multiband mucosectomy in 1060 resections in Barrett's esophagusEndoscopy, 2011
- Stepwise radical endoscopic resection versus radiofrequency ablation for Barrett's oesophagus with high-grade dysplasia or early cancer: a multicentre randomised trialGut, 2011
- Safety and efficacy of endoscopic spray cryotherapy for Barrett's esophagus with high-grade dysplasiaGastrointestinal Endoscopy, 2010
- Radiofrequency Ablation in Barrett's Esophagus with DysplasiaThe New England Journal of Medicine, 2009
- Endoscopic Ablation of Barrett’s Esophagus Using the Halo® SystemDigestive Diseases, 2008
- The Development and Validation of an Endoscopic Grading System for Barrett’s Esophagus: The Prague C & M CriteriaGastroenterology, 2006
- The Vienna classification of gastrointestinal epithelial neoplasiaGut, 2000
- Symptomatic Gastroesophageal Reflux as a Risk Factor for Esophageal AdenocarcinomaThe New England Journal of Medicine, 1999
- Palliative intubation of oesophagogastric neoplasms at fibreoptic endoscopy.Gut, 1982