title: Ablation of nonneoplastic Barrett's mucosa using argon plasma coagulation with concomitant esomeprazole therapy (APBANEX): a prospective multicenter evaluation.
abstract: BACKGROUND
  Complete reversal of Barrett's epithelium (BE) achieved by treatment with argon plasma coagulation (APC) is variable. The aim of this prospective study was to evaluate the effectiveness of high-power APC in a multicenter trial.
  
  
  METHODS
  In seven study centers, 60 patients (mean age 57, range 27-77) with nonneoplastic BE (length 1-8 cm) were recruited for treatment with high-power APC (90 W) in combination with esomeprazole 80 mg/day. Video endoscopy, chromoendoscopy, and four-quadrant biopsies (4QB) were carried out during baseline endoscopy and regular intervals. The effect of ablation was classified as complete remission (CR), partial remission, or minor response.
  
  
  RESULTS
  Fifty-one of the 60 patients completed ablation therapy. Three patients were lost to follow-up (FU). After a mean of 2.6 APC sessions (range 1-5) and a mean FU of 14 months (range 12-32), CR was achieved in 37 of 48 patients (77%). Major complications occurred in five of 51 patients (9.8%).
  
  
  CONCLUSIONS
  Complete ablation of BE can be achieved in a high percentage of patients even in a multicenter design using high-power APC. However, APC has a relevant morbidity. Therefore, ablation of nonneoplastic BE cannot be recommended generally because incidence of cancer in BE is low.
authors.affiliation: Department of Internal Medicine II, HSK Wiesbaden, Wiesbaden, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Manner
authors.forename: Andrea
authors.initials: A
authors.lastname: May
authors.forename: Stephan
authors.initials: S
authors.lastname: Miehlke
authors.forename: Stephan
authors.initials: S
authors.lastname: Dertinger
authors.forename: Bernd
authors.initials: B
authors.lastname: Wigginghaus
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schimming
authors.forename: Walter
authors.initials: W
authors.lastname: Krämer
authors.forename: Gabriele
authors.initials: G
authors.lastname: Niemann
authors.forename: Manfred
authors.initials: M
authors.lastname: Stolte
authors.forename: Christian
authors.initials: C
authors.lastname: Ell
mesh_terms: D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001128:Argon / Q000627:therapeutic use; D001471:Barrett Esophagus / Q000188:drug therapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D064098:Esomeprazole / Q000627:therapeutic use*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000897:Anti-Ulcer Agents; D001128:Argon; D064098:Esomeprazole