title: Ablation of Barrett's epithelium by endoscopic argon plasma coagulation in combination with high-dose omeprazole.
abstract: BACKGROUND
  Barrett's esophagus is a premalignant condition induced by gastroesophageal reflux. The aim of this prospective study was to assess the efficacy of argon plasma coagulation in combination with high-dose omeprazole therapy to ablate nondysplastic Barrett's epithelium.
  
  
  METHODS
  In 73 patients with histologically confirmed Barrett's epithelium, argon plasma coagulation was used in combination with maximal acid suppression (omeprazole 40 mg three times a day). Histologic and endoscopic changes were evaluated at 6- and 12-month intervals.
  
  
  RESULTS
  In 69 of 70 patients (98.6%) complete squamous regeneration was achieved after a median of 2 argon plasma coagulation sessions (range 1 to 5). During a median follow-up of 12 months (range 2 to 51 months) there has been no relapse or evidence of the development of dysplasia under continuous acid suppression. Three patients (4.3%) developed a mild stricture of the distal esophagus that resolved after a single session of bougie dilation.
  
  
  CONCLUSIONS
  In our experience, argon plasma coagulation in combination with high-dose omeprazole treatment is an effective and safe technique for complete ablation of nondysplastic Barrett's epithelium. Restoration of squamous mucosa after argon plasma coagulation appears to be long-lasting.
authors.affiliation: Medical Department I, Technical University Hospital Carl Gustav Carus, Dresden, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Schulz
authors.forename: S
authors.initials: S
authors.lastname: Miehlke
authors.forename: D
authors.initials: D
authors.lastname: Antos
authors.forename: K U
authors.initials: KU
authors.lastname: Schentke
authors.forename: M
authors.initials: M
authors.lastname: Vieth
authors.forename: M
authors.initials: M
authors.lastname: Stolte
authors.forename: E
authors.initials: E
authors.lastname: Bayerdörffer
mesh_terms: D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D001471:Barrett Esophagus / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage*; D011446:Prospective Studies
chemical_list: D000897:Anti-Ulcer Agents; D009853:Omeprazole