Esophageal Adenocarcinoma Associated with Barrett's Esophagus: Long‐term Management with Laser Ablation

Document Type

Journal Article

Publication Date

1-1-1995

Journal

The American Journal of Gastroenterology

Volume

90

Issue

12

DOI

10.1111/j.1572-0241.1995.tb08146.x

Abstract

We report the use of neodymium:yttrium‐aluminumgarnet (Nd:YAG) laser ablation to treat high‐grade dysplasia and intramucosal esophageal adenocarcinoma associated with Barrett's esophagus in a patient who refused surgery. Throughout laser therapy, the patient received omeprazole 40 mg/day. After 11/2 yr, five laser treatments totaling 22,055 J given over a period of 13 months achieved squamous reepithelialization and absence of malignant transformation in the first area in which carcinoma was diagnosed. Squamous reepithelialization was maintained 1 yr later, confirming recent reports that photoahlation plus omeprazole can achieve regression of Barrett's esophagus. During the last year of follow‐up, a second contiguous area discovered to contain carcinoma was treated three times by photoablation. with a total of 13,164 J; biopsy showed only low‐grade dysplasia in this area after two laser treatments totaling 8,108 J. No complications were seen during or after any of the laser sessions, and the patient remained asymptomatic 21/2 yr after the first photoablalion and 3 yr after presentation. Copyright © 1995, Wiley Blackwell. All rights reserved

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