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Endoscopy 2008; 40(12): 1026-1032
DOI: 10.1055/s-0028-1103414
Total Barrett Eradication review section

© Georg Thieme Verlag KG Stuttgart · New York

Argon plasma coagulation, bipolar cautery, and cryotherapy: ABC's of ablative techniques

J.  A.  Dumot1 , B.  D.  Greenwald2
  • 1Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
  • 2Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine and Greenebaum Cancer Center, Baltimore, Maryland, USA
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Publication History

Publication Date:
08 December 2008 (online)

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A variety of endoscopic ablation modalities are available for the treatment of Barrett’s esophagus. Multiple studies have evaluated the use of argon plasma coagulation, mostly in nondysplastic Barrett’s esophagus. Significant variations in technique, end points, and follow-up exist between studies, but in most cases argon plasma coagulation is associated with unacceptable rates of persistent intestinal metaplasia and recurrence after completion of treatment. In addition, serious adverse events including perforation and stricture formation are reported. Multipolar electrocoagulation has been studied less thoroughly, but in prospective trials significant rates of persistent and recurrent intestinal metaplasia have also been reported. Lasers and heater probes have been tried in small numbers. Endoscopic cryotherapy ablation is a relatively new technique with studies focusing on high-grade dysplasia and early-stage cancer in high-risk patients. It has an acceptable safety profile, and early results show response in a significant number of patients in whom other modalities have failed.

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B. D. GreenwaldMD 

Division of Gastroenterology and Hepatology

22 South Greene Street, Rm N3W62
Baltimore
MD 21201–1595
USA

Fax: +1-410-3288315

Email: bgreenwa@medicine.umaryland.edu

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