Endoscopic Ablation of Barrett’s Columnar Lined Epithelium

  • Jeffrey H. Peters
  • Ross M. Bremner
  • Cedric G. Bremner

Abstract

The condition whereby the tubular esophagus is lined with columnar epithelium rather than squamous epithelium was first described by Norman Barrett in 1950.1 He incorrectly believed it to be congenital in origin. It is now realized that it is an acquired abnormality, occurring in 7% to 10% of patients with gastroesophageal reflux disease (GERD), and represents the end stage of the natural history of this disease.2 It is also understood to be distinctly different from the congenital condition in which islands of mature gastric columnar epithelium are found in the upper half of the esophagus.

Keywords

Photodynamic Therapy Intestinal Metaplasia Endoscopic Mucosal Resection Antireflux Surgery Argon Plasma Coagulation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Spechler SJ. The columnar lined esophagus: history, terminology and clinical issues. Gastroenterol Clin North Am 1997; 26: 455–466.PubMedCrossRefGoogle Scholar
  2. 2.
    Peters JH. The surgical management of Barrett’s esophagus. Gastroenterol Clin North Am 1997; 26: 647–668.PubMedCrossRefGoogle Scholar
  3. 3.
    Chandrasoma P. Norman Barrett: so close, yet 50 years away from the truth. J Gastrointest Surg 1999; 3: 7–14CrossRefGoogle Scholar
  4. 4.
    Sawhney RA, Shields HM, Allan CH, et al. Morphological characterization of the squamo-columnar junction of the esophagus in patients with and without Barrett’s epithelium. Dig Dis Sci 1996; 41: 1088–1098.PubMedCrossRefGoogle Scholar
  5. 5.
    Shields HM, Zwas F, Antonioli DA, et al. Detection by scanning electron microscopy of a distinctive esophageal surface cell at the junction of squamous and Barrett’s epithelium. Dig Dis Sci 1993; 38: 97–108.PubMedCrossRefGoogle Scholar
  6. 6.
    Salo JA, Kivilaakso EO, Kiviluoto TA, Virtanen IO. Cytokeratin profile suggests metaplastic epithelial transformation in Barrett’s oesophagus. Ann Med 1996; 28: 305–309.PubMedCrossRefGoogle Scholar
  7. 7.
    Boch JA, Shields HM, Antonioli DA, et al. Distribution of cytokeratin markers in Barrett’s specialized columnar epithelium. Gastroenterology 1997; 112: 760–765.PubMedCrossRefGoogle Scholar
  8. 8.
    Hameeteman W, Tytgat GNJ, Houthoff HJ, Van Den Tweel JG. Barrett’s esophagus: development of dysplasia and adenocarcinoma. Gastroenterology 1989; 96: 1249–1256.PubMedGoogle Scholar
  9. 9.
    Zhuang Z, Vortmeyer AO, Mark EJ, et al. Barrett’s esophagus: metaplastic cells with loss of heterozygosity at the APC gene locus are clonal precursor to invasive adenocarcinoma. Cancer Res 1996; 56: 1961–1964.PubMedGoogle Scholar
  10. 10.
    Brandt LJ, Blansky RL, Kauvar DR. Repeat laser therapy of recurrent Barrett’s epithelium: success with anacidity [letter]. Gastrointest Endosc 1995; 4: 267.CrossRefGoogle Scholar
  11. 11.
    Sampliner RE. Ablative therapies for the 24. columnar-lined esophagus. Gastroenterol Clin North Am 1997; 26: 685–694.PubMedCrossRefGoogle Scholar
  12. 12.
    Bremner RM, Mason RJ, Bremner CG, et al. Ultrasonic epithelial ablation of the lower esoph- 25. agus without stricture formation. Surg Endosc 1998; 12: 346–347.CrossRefGoogle Scholar
  13. 13.
    Sampliner RE, Fennerty B, Garewal HS. Reversal of Barrett’s esophagus with acid suppression and multipolar electrocoagulation: preliminary results. Gastrointest Endosc 1996; 44 (5): 532–535.PubMedCrossRefGoogle Scholar
  14. 14.
    Jackson FW, Husson M, Wright S, et al. Eradication of Barrett’s epithelium with multipolar electrocautery. Gasteointest Endosc 1997;45: AB71.Google Scholar
  15. 15.
    Kovacs BJ. Reversal of Barrett’s esophagus with multipolar coagulation. Is acid suppression important? Gasteointest Endosc 1997;45:AB72.Google Scholar
  16. 16.
    Garcia MC, Brandalise NA, Deliza R, et al. Regression of childhood Barrett’s esophageal mucosa by antireflux surgery and bipolar electrocoagulation. J Pediatr Surg 1998; 33 (5): 747–749.CrossRefGoogle Scholar
  17. 17.
    Sampliner RE, Camargo E, Faigel D, et al. Efficacy and safety of reversal of Barrett’s esophagus with high dose omeprazole and electrocoagulation. Gastroenterology 1999; 116: A298.Google Scholar
  18. 18.
    Katzka DA, Paoletti V, Leite L, Castell DO. Prolonged ambulatory pH monitoring in patients with persistent gastroesophageal reflux disease symptoms; testing while on therapy identifies the need for more aggressive antireflux therapy. Am J Gastroenterol 1996; 91: 2110–2113.PubMedGoogle Scholar
  19. 19.
    Van Hillegersberg R. Fundamentals of laser surgery. Eur J Surg 1997; 163: 3–12.PubMedGoogle Scholar
  20. 20.
    Berenson MM, Johnson TD, Markowitz NR, Buchi KN, Samowitz WS. Restoration of squamous mucosa after ablation of Barrett’s esophageal epithelium. Gastroenterology 1993; 104: 1686–1691.PubMedGoogle Scholar
  21. 21.
    Salo JA, Hietala EM, Nemlander A, et al. Reversal of Barrett’s esophagus by endoscopic laser ablation and antireflux surgery. Gastroenterology 1994; 106: A171.Google Scholar
  22. 22.
    Barham CP, Jones RL, Biddlestone LR, Hardwick RH, Shepherd NA, Batt H. Photo thermal laser ablation of Barrett’s oesophagus: endoscopic and histological evidence of squamous reephithelialisation. Gut 1997; 41: 281–284.PubMedCrossRefGoogle Scholar
  23. 23.
    Carrazone A, Bonavina L, Segalin A. Endoscopic 37. laser ablation of Barrett’s mucosa followed by Nissen fundoplication: results of a pilot study. Gastroenterology 1998; 114 (4): S00–39A.Google Scholar
  24. 24.
    Salo JA, Salminen JT, Kiviluoto TA, et al. Treatment of Barrett’s esophagus by endoscopic laser ablation and antireflux surgery. Ann Surg 1998; 227: 40–44.PubMedCrossRefGoogle Scholar
  25. 25.
    Byrne JP, Armstrong GR, Attwood SEA. Restoration of the normal squamous lining in Barrett’s esophagus by argon beam plasma coagulation. Am J Gastroenterol 1998; 93: 1810–1815.PubMedCrossRefGoogle Scholar
  26. 26.
    Attwood SEA, Byrne JP, Armstrong GR. A detailed analysis of the pattern of neo-squamous epithelium following endoscopic argon beam plasma coagulation of Barrett’s oesophagus. Gastroenterology 1998;114(4):G0245(A).Google Scholar
  27. 27.
    Grund KE, Storek D, Farin G. Endoscopic argon plasma coagulation (APC): first clinical experiences in flexible endoscopy. Endosc Surg Allied Technol 1994; 2: 42–46.PubMedGoogle Scholar
  28. 28.
    Porthun M, Brand B, Thonke F, et al. Endoscopic therapy of Barrett’s esophagus using argon-plasma-coagulation (APC). Gastroenterology 1998;114(4):G1069A.Google Scholar
  29. 29.
    Martin WR, Benz C, Jakobs R, Riemann JF. Argoa plasma coagulation (APC) in patients with Barrett’s esophagus. Gastroenterology 1998;114(4):G0888A.Google Scholar
  30. 30.
    Mórk H, Al-taie O, Kraus M, et al. Regeneration of squamous mucosa after argon plasma coagulation (APC) of Barrett’s epithelium. Gastroenterology 1998; (abs), 114(4):G0958.Google Scholar
  31. 31.
    Van Laethem JL, Devière J, Peny MD, Cremer M. One year follow-up after complete eradication of Barrett’s esophagus using argon plasma coagulation. Gut 1998; 43: 747–751.PubMedCrossRefGoogle Scholar
  32. 32.
    Stüker D, Dopieralski A, Zindel C, Farin G, Grund KE. Argon plasma coagulation (APC) for ablation of Barrett’s epithelium: first clinical results in 21 patients. Gastroenterology 1998;114(4):G1212A.Google Scholar
  33. 33.
    Schulz. Ablation of Barrett’s epithelium by endoscopic argon plasma coagulation used in combination with high-dose omaprazole. Gastroentrol. 1999; 116 (4): G1339.Google Scholar
  34. 34.
    Wang KK. Current status of photodynamic therapy of Barrett’s esophagus. Gastroint Endosc 1999; 49: 520–23.CrossRefGoogle Scholar
  35. 35.
    Webber J, Herman M, Kessel D, Fromm D. Current concepts in gastrointestinal photodynamic therapy. Ann Surg 1999; 230: 12–23.PubMedCrossRefGoogle Scholar
  36. 36.
    Dougherty TJ, Gomer CJ, Henderson BW, Photodynamic therapy. J Natl Cancer Inst 1998; 90: 889–905.PubMedCrossRefGoogle Scholar
  37. 37.
    Bugelski PJ, Porter CW, Dougherty TJ, et al. Autoradiographic distribution of hematoporphrin derivative in normal and tumor tissue of plasia in columnar-lined (Barrett’s) oesophagus the mouse. Cancer Res 1981; 41: 4606–4612.PubMedGoogle Scholar
  38. 38.
    Yuan J, Mahama-Reluc PA, Fournier RL, Hamp ton JA. Predictions of mathematical models of tissue oxygenation and generation of singlet oxygen during photodynamic therapy. Radiat Res Bergh H, Monnier P. Clinical photodynamic 1997; 148: 386–396.Google Scholar
  39. 39.
    Overholt BF, Panjehpour M, DeNovo RC, Peter sen MG. Photodynamic therapy for esophageal cancer using a 180° windowed esophageal bal loon. Lasers Surg Med 1994; 14: 27–33.PubMedCrossRefGoogle Scholar
  40. 40.
    Kennedy JC, Pottier RH. Endogenous propor phyrin IX a clinically useful photosensitizer for photodynamic therapy. J Photochem Photobiol B Biol 1992; 14: 275–292.CrossRefGoogle Scholar
  41. 41.
    Ortner M, Zumbusch K, Liebetruth J, et al. Gastroenterology 1998;114:A709. Photodynamic ter local administration of 5 aminolevulinic acid. Gastroenterology 1997; 112: A633.Google Scholar
  42. 42.
    Wang KK, Wong Kee Song M, Nijhawan P, Nour bakhsh A, Anderson M, Balm R. Clinical course of photodynamic therapy indirect esophageal Ferguson MK, Naunheim KS. Resection for Bar strictures. Gastroenterology 1998; 114: G2894.Google Scholar
  43. 43.
    Laukka MA, Wang KK. Initial results using low-dose photodynamic therapy in the treatment of Barrett’s esophagus. Gastrointest Endosc 1995; 42: 59–63.PubMedCrossRefGoogle Scholar
  44. 44.
    Lambert R. Endoscopic treatment of esophago dynamic therapy with porfimer sodium versus gastric tumors. Endoscopy 1998; 30: 80–93.PubMedCrossRefGoogle Scholar
  45. 45.
    Ackroyd R, Davis MF, Brown NJ, Stephenson TJ, Stoddard CJ, Reed MWR. Photodynamic therapy for Barrett’s esophagus; A prospective randomi sed placebo-controlled trial. Endoscopy 1997; 29: E17.CrossRefGoogle Scholar
  46. 46.
    Altorki NK, Sunagawa M, Little AG, Skinner DB. High-grade dysplasia in the columnar-lined esophagus. Am J Surg 1991; 161: 99–100.CrossRefGoogle Scholar
  47. 47.
    Overholt BF, Panjehpour M. Photodynamic ther Am 58. Tajiri H, Daikuzono N, Joffe SN, Oguro Y. Photo J Gastroenterol 1996; 91: 1712–1723.Google Scholar
  48. 48.
    Overholt BF, Panjehpour M. Photodynamic ther Gastrointest Endosc with thermal ablation eliminates Barrett’s esophagus. Gastrointest Endosc 1997;45 (4):AB76.Google Scholar
  49. 49.
    Overholt BF, Panjehpour M, Haydek JM. Photodynamic therapy for Barrett’s esophagus: followup in 100 patients. Gastrointest Endosc 1999; 49: 1–7.PubMedCrossRefGoogle Scholar
  50. 50.
    Gossner L, Stolte M, Sroka R, et al. Photody oesophageal, duodenal and colorectal tumours namic ablation of high-grade dysplasia and early cancer in Barrett’s esophagus by means of 5 aminolevulinic for esophageal tumors. Arch Surg 1998; 114: 448–455.Google Scholar
  51. 51.
    Barr H, Shepherd NA, Dix A, Roberts DJ, Tan WC, Krasner N. Eradication of high-grade dys plasia in columnar-lined (Barrett’s) oesophagus by photodynamic therapy with endogenously generated protoporphyrin IX (see comments). Lancet 1996; 348: 584–585.PubMedCrossRefGoogle Scholar
  52. 52.
    Grosjean P, Wagnieres G, Fontolliet C, Vander Bergh H, Monnier P. Clinical photodynamic therapy for superficial cancer in the oesophagus and bronchi: 514 nm compared with 630 nm light irradiation after sensitization with photofrin. Br J Cancer 1998; 77: 1989–1995.PubMedCrossRefGoogle Scholar
  53. 53.
    Schember D, Lightdale C, Ligresti R, et al. Photodynamic therapy for high grade dysplasia phyrin IX a clinically useful photosensitizer for and early adenocarcinoma of the esophago-and early adenocarcinoma of the esophagogastric junction and gastric cardia in elderly patients with short segment Barrett’s esophagus. Gastroenterology 1998; 114: A709.Google Scholar
  54. 54.
    Zoepf T, Preclik G, Boeck W, et al. Photodynamic therapy with 5-aminolaevulinic acid for the treatment of dysplasia and early carcinoma in the up-per GI tract. Gastroenterology 1998; 114: A709.CrossRefGoogle Scholar
  55. 55.
    Ferguson MK, Naunheim KS. Resection for Bar-rett’s mucosa with high-grade dysplasia: impli-cations for prophylactic photodynamic therapy.J Thorac Cardiovasc Surg 1997; 114: 824–829.Google Scholar
  56. 56.
    Lightdale CJ, Heier SK, Marcon NE, et al. Photo-dynamic therapy with porfimer sodium versusthermal ablation therapy with Nd:YAG laser for palliation of esophageal cancer: a multicenter randomized trial. Gastrointest Endosc 1995; 42 (6): 507–512.PubMedCrossRefGoogle Scholar
  57. 57.
    Foultier MT, Vonarx-Coinsman V, Xavier de Brito L, Morlet L, Robillard M, Patrice T. DNA or cell kinetics flow cytometry. Analysis of 33 small gastrointestinal cancers treated by photo-cynamic therapy. Cancer 1994; 73: 1595–1607.PubMedCrossRefGoogle Scholar
  58. 58.
    Tajiri H, Daikuzono N, Joffe SN, Oguro Y. Photo-dynamic therapy in early gastrointestinal cancer.J Gastroenterol 1996; 91: 1712–1723.Google Scholar
  59. 59.
    Barr H, Dix T, Roberts D, Shepherd N. Photo-dynamic therapy for high grade dysplasia and ad-enocarcinoma in Barrett’s oesophagus using photosensitisation with amino-laevulinic acids. Lasers Med Sci 1994; 9: 219.Google Scholar
  60. 60.
    Regula J, MacRobert AJ, Gorchein A, et al. Photosensitisation and photodynamic therapy of Photody oesophageal, duodenal and colorectal tumours using 5-aminolaevulinic acid induced protoporphyrin IX-a pilot study. Gut 1995; 36: 67–75.PubMedCrossRefGoogle Scholar
  61. 61.
    McCaughan JS, Nims TA, GuyJT, Hicks WJ, Williams TE, Laufman LR. Photodynamic therapy for esophageal tumors. Arch Surg 1989; 124: 74–80.PubMedCrossRefGoogle Scholar
  62. 62.
    McCaughan JS. Photodynamic therapy for endobronchial and esophageal tumors: an overview. J Clin Laser Med Surg 1996; 14: 223–233.PubMedGoogle Scholar
  63. 63.
    Inoue H. Endoscopic mucosal resection for esophageal and gastric mucosal cancers. Can J Gastroenterol 1998; 12 (5): 355–359.PubMedGoogle Scholar
  64. 64.
    Ell C, Schmidt H, May A, Endoscopic resection of “low risk” Barrett’s carcinomas. Gastroenterol 1999; 116: A155.Google Scholar
  65. 65.
    Moérk H, Jakob F, Barth T, et al. Restoration of squamous epithelium in Barrett’s esophagus (BE) leads to marked changings in the expression pattern of glutathione peroxidaze (GPX) isoforms. Gastroenterol 1999; 116: A257.Google Scholar
  66. 66.
    Fennerty MB. Perspectives on endoscopic eradication of Barrett’s esophagus; who are appropriate candidates and what is the best method. Gastrointest Endosc 1999; 49: S24–28.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Jeffrey H. Peters
  • Ross M. Bremner
  • Cedric G. Bremner

There are no affiliations available

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