Dtsch Med Wochenschr 2015; 140(20): 1533-1536
DOI: 10.1055/s-0041-103505
Klinischer Fortschritt
Verdauungs- und Stoffwechselerkrankungen
© Georg Thieme Verlag KG Stuttgart · New York

Refluxerkrankung und Barrett-Ösophagus

Gastroesophageal reflux disease and Barrett‘s dysplasia
Oliver Pech
1   Klinik für Gastroenterologie und interventionelle Endoskopie, Krankenhaus Barmherzige Brüder Regensburg
› Author Affiliations
Further Information

Publication History

Publication Date:
07 October 2015 (online)

Zusammenfassung

Die neue Leitlinie zur Refluxerkrankung und zum Barrett-Ösophagus bringt einige Neuerungen in der Diagnostik und Therapie. Gerade bei der endoskopischen Therapie früher Neoplasien im Barrett-Ösophagus hat sich die differenzierte Therapie mit der Kombination von ER und Ablation (z. B. Radiofrequenzablation) etabliert.

Abstract

The new guideline for reflux disease and Barrettʼs oesophagus offers some news in diagnosis and therapy. Especially in the endoscopic treatment of early neoplasia in Barrett‘s oesophagus the combination of endoscopic resection and ablation (e. g. radiofrequency ablation) has now been established.

 
  • Literatur

  • 1 Bennett C, Vakil N, Bergman J et al. Consensus Statements for Management of Barrett’s Dysplasia and Early-Stage Esophageal Adenocarcinoma, Based on a Delphi Process. Gastroenterology 2012; 143: 336-346
  • 2 Koop H, Fuchs KH, Labenz J et al. S2k-Leitlinie: Gastroösophageale Refluxkrankheit unter Federführung der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten. Z Gastroenterol 2014; 52: 1299-12346
  • 3 Pohl J, Pech O, May A et al. Incidence of macroscopically occult neoplasias in Barrett’s esophagus: are random biopsies dispensable in the era of advanced endoscopic imaging?. Am J Gastroenterol 2010; 105: 2350-2366
  • 4 Longcroft-Wheaton G, Brown J, Basford P et al. Duration of acetowhitening as a novel objective tool for diagnosing high risk neoplasia in Barrett’s esophagus: a prospective cohort trial. Endoscopy 2013; 45: 426-432
  • 5 Desai TK, Krishnan K, Samala N. The incidence of oesophageal adenocarcinoma in non-dysplastic Barrett’s oesophagus: a meta-analysis. Gut 2012; 61: 970-976
  • 6 Curvers WL, ten Kate FJ, Krishnadath KK et al. Low-grade dysplasia in Barrett’s esophagus: overdiagnosed and underestimated. Am J Gastroenterol 2010; 105: 1523-1530
  • 7 Phoa KN, van Vilsteren FG, Weusten BL et al. Radiofrequency ablation vs endoscopic surveillance for patients with Barrett esophagus and low-grade dysplasia: a randomized clinical trial. JAMA 2014; 311: 1209-1217
  • 8 Ell C, May A, Gossner L et al. Endoscopic mucosal resection of early cancer and high-grade dysplasia in Barrett’s esophagus. Gastroenterology 2000; 118: 670-677
  • 9 May A, Gossner L, Pech O et al. Local endoscopic therapy for intraepithelial high-grade neoplasia and early adenocarcinoma in Barrett’s oesophagus: acute-phase and intermediate results of a new treatment approach. Eur J Gastroenterol Hepatol 2002; 14: 1085-1091
  • 10 Pech O, Behrens A, May AD et al. Long-Term Results and Risk Factor Analysis for Recurrence after Curative Endoscopic Therapy in 349 Patients with High-Grade Intraepithelial Neoplasia and Mucosal Adenocarcinoma in Barrett’s Oesophagus. Gut 2008; 57: 1200-1206
  • 11 Manner H, Neugebauer A, Scharpf M et al. The tissue effect of argon-plasma coagulation with prior submucosal injection (Hybrid-APC) versus standard APC: A randomized ex-vivo study. United European Gastroenterol J 2014; 2: 383-890
  • 12 Manner H, Rabenstein T, Braun K et al. What should we do with the remainder of the Barrett’s segment after endoscopic resection of early Barrett’s cancer?. Endoscopy 2014; 46: 6-12
  • 13 Shaheen NJ, Sharma P, Overholt BF et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med 2009; 360: 2277-2288
  • 14 Phoa KN, Pouw RE, Bisschops R et al. Multimodality endoscopic eradication for neoplastic Barrett oesophagus: results of an European multicentre study (EURO-II). Gut 2015; doi: 10.1136/gutjnl-2015-309298
  • 15 Pech O, May A, Manner H et al. Long-Term Efficacy and Safety of Endoscopic Resection for Patients with Mucosal Adenocarcinoma of the Esophagus. Gastroenterology 2014; 146: 652-660
  • 16 Manner H, Pech O, Heldmann Y et al. Efficacy, safety, and long-term results of endoscopic treatment for early stage adenocarcinoma of the esophagus with low-risk sm1 invasion. Clin Gastroenterol Hepatol 2013; 11: 630-635
  • 17 Neuhaus H, Terheggen G, Rutz EM et al. Endoscopic submucosal dissection plus radiofrequency ablation of neoplastic Barrett’s esophagus. Endoscopy 2012; 44: 1105-1113
  • 18 Probst A, Aust D, Märkl B et al. Early esophageal cancer in Europe: endoscopic treatment by endoscopic submucosal dissection. Endoscopy 2015; 47: 113-121