title: Barrett's oesophagus: long-term follow-up after complete ablation with argon plasma coagulation and the factors that determine its recurrence.
abstract: BACKGROUND
  Argon plasma coagulation seems to be a promising technique for ablation of Barrett's oesophagus, yet few long-term efficacy data are available.
  
  
  OBJECTIVE
  To report on a long-term follow-up and the factors that determine the recurrence of intestinal metaplasia in a cohort of patients with non dysplastic, intestinal type Barrett's oesophagus, after complete ablation of the metaplastic mucosa with argon plasma coagulation.
  
  
  METHODS
  Ninety-six patients underwent endoscopic argon plasma coagulation with adequate acid suppression obtained through a continuous omeprazole therapy (50 patients) or through laparoscopic fundoplication (46 patients). Complete ablation was achieved in 94 patients who underwent follow-up. Endoscopic and histological examinations were performed every 12 months.
  
  
  RESULTS
  The median follow-up of the patients was 36 months (range 18-98). A recurrence of intestinal metaplasia was found in 17 patients (18%), with an annual recurrence rate of 6.1%. Neither dysplasia, nor adenocarcinoma were found during the follow-up. Through the use of logistic regression analysis, previous laparoscopic fundoplication was associated with a reduced recurrence rate of intestinal metaplasia (odds ratio 0.30, 95% confidence interval 0.10-0.93).
  
  
  CONCLUSIONS
  The long-term recurrence of intestinal type Barrett's oesophagus was low after complete ablation with argon plasma coagulation. The control of oesophageal acidity acid exposure with laparoscopic fundoplication seems to reduce the recurrence rate.
authors: U.O. Gastroenterologia ed Endoscopia Digestiva, Osp. Mauriziano di Torino, Torino, Italy. ro.ferraris@libero.it
authors: R
authors: R
authors: Ferraris
authors: M
authors: M
authors: Fracchia
authors: M
authors: M
authors: Foti
authors: L
authors: L
authors: Sidoli
authors: S
authors: S
authors: Taraglio
authors: L
authors: L
authors: Vigano'
authors: C
authors: C
authors: Giaccone
authors: F
authors: F
authors: Rebecchi
authors: G
authors: G
authors: Meineri
authors: C
authors: C
authors: Senore
authors: A
authors: A
authors: Pera
mesh_terms: D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000601:surgery*; D004947:Esophagus / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D055502:Secondary Prevention; D016896:Treatment Outcome