Schulz H, Miehlke S, Antos D, Schentke K U, Vieth M, Stolte M, Bayerdörffer E
Medical Department I, Technical University Hospital Carl Gustav Carus, Dresden, Germany.
Gastrointest Endosc. 2000 Jun;51(6):659-63.
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.
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.
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.
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.
巴雷特食管是一种由胃食管反流引起的癌前病变。这项前瞻性研究的目的是评估氩等离子体凝固术联合大剂量奥美拉唑治疗对非发育异常的巴雷特上皮细胞的消融效果。
在73例经组织学确诊为巴雷特上皮细胞的患者中，采用氩等离子体凝固术联合最大程度的抑酸治疗（奥美拉唑40毫克，每日三次）。每隔6个月和12个月评估组织学和内镜检查的变化。
70例患者中的69例（98.6%）在平均进行2次氩等离子体凝固术（范围1至5次）后实现了完全鳞状上皮再生。在平均12个月的随访期内（范围2至51个月），在持续抑酸的情况下没有复发或发育异常的迹象。3例患者（4.3%）出现了轻度的食管远端狭窄，在单次探条扩张后缓解。
根据我们的经验，氩等离子体凝固术联合大剂量奥美拉唑治疗是完全消融非发育异常的巴雷特上皮细胞的一种有效且安全的技术。氩等离子体凝固术后鳞状黏膜的恢复似乎是持久的。
