Prasad GA, Wang KK, Joyce AM, Kochman ML, Lutzke LS, Borkenhagen LS. Endoscopic therapy in patients with Barrett's esophagus and portal hypertension.
Gastrointest Endosc 2007;
65:527-31. [PMID:
17321262 DOI:
10.1016/j.gie.2006.11.024]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2006] [Accepted: 11/14/2006] [Indexed: 12/13/2022]
Abstract
BACKGROUND
Endoscopic mucosal resection has been used to stage and treat early neoplasia in Barrett's esophagus. The ability to do this in the setting of portal hypertension has not been reported.
OBJECTIVE
Our purpose was to describe the feasibility and efficacy of endoscopic mucosal resection in patients with portal hypertension and Barrett's esophagus.
DESIGN
Retrospective case series.
SETTING
Two tertiary referral centers.
PATIENTS
Patients with Barrett's esophagus and high-grade dysplasia or adenocarcinoma in the setting of portal hypertension.
INTERVENTION
Endoscopic mucosal resection of endoscopically visible lesions.
MAIN OUTCOME MEASUREMENTS
Complete resection of neoplastic lesion, lack of variceal bleeding.
RESULTS
Four patients were treated with endoscopic mucosal resection a total of 5 times. Endoscopic mucosal resection was successfully performed without significant GI bleeding.
LIMITATIONS
This preliminary case series describes feasibility of the procedure. Whether this can be generalized remains to be determined, although it may be an option in poor surgical candidates.
CONCLUSIONS
Endoscopic mucosal resection appears to be relatively safe in selected patients with portal hypertension and Barrett's esophagus. Further studies are needed to confirm these findings.
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