Kia Leila, Komanduri Srinadh
Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North Saint Clair, Suite 1400, Chicago, IL 60611, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North Saint Clair, Suite 1400, Chicago, IL 60611, USA.
Gastrointest Endosc Clin N Am. 2017 Jul;27(3):515-529. doi: 10.1016/j.giec.2017.02.008.
Endoscopic eradication therapy is effective and durable for the treatment of Barrett's esophagus (BE), with low rates of recurrence of dysplasia but significant rates of recurrence of intestinal metaplasia. Identified risk factors for recurrence include age and length of BE before treatment and may also include presence of a large hiatal hernia, higher grade of dysplasia before treatment, and history of smoking. Current guidelines for surveillance following ablation are limited, with recommendations based on low-quality evidence and expert opinion. New modalities including optical coherence tomography and wide-area tissue sampling with computer-assisted analysis show promise as adjunctive surveillance modalities.
内镜下根除治疗对Barrett食管（BE）的治疗有效且持久，发育异常复发率低，但肠化生复发率较高。已确定的复发风险因素包括年龄和治疗前BE的长度，也可能包括存在大的食管裂孔疝、治疗前发育异常程度较高以及吸烟史。目前消融后监测的指南有限，其建议基于低质量证据和专家意见。包括光学相干断层扫描和计算机辅助分析的广域组织采样在内的新方法有望作为辅助监测手段。
