Spadaccini Marco, Alfarone Ludovico, Chandrasekar Viveksandeep Thoguluva, Maselli Roberta, Capogreco Antonio, Franchellucci Gianluca, Massimi Davide, Fugazza Alessandro, Colombo Matteo, Carrara Silvia, Facciorusso Antonio, Bhandari Pradeep, Sharma Prateek, Hassan Cesare, Repici Alessandro
Department of Biomedical Sciences, Humanitas University, 20089 Rozzano, Italy.
Digestive Endoscopy Unit, Department of Endoscopy, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089 Rozzano, Italy.
Life (Basel). 2023 Apr 15;13(4):1023. doi: 10.3390/life13041023.
Over the last two decades, endoscopic eradication therapy has been established as the therapeutic strategy of choice for patients with Barrett's oesophagus-related dysplasia and early oesophageal adenocarcinoma. With a multimodal approach, ablative therapies have been highly effective in achieving remarkable eradication rates of metaplastic epithelium with an acceptable adverse event rate. Among ablative techniques, radiofrequency ablation is currently considered as the first-line option as its efficacy and safety are strongly supported by relevant data. Nevertheless, radiofrequency ablation is costly, and not universally available, or applicable to every situation. Moreover, primary failure and recurrence rates are not negligible. In the last few years, cryotherapy techniques and hybrid argon plasma coagulation have been increasingly assessed as potential novel ablative therapies. Preliminary data have been promising and suggest that they may even have a role as first-line options, alternatively to radiofrequency ablation. The aim of this review is to provide a practical guide for the ablation of Barrett's oesophagus, with emphasis on the different ablative options.
在过去二十年中，内镜下根除治疗已成为巴雷特食管相关异型增生和早期食管腺癌患者的首选治疗策略。通过多模式方法，消融治疗在实现化生上皮的高根除率方面非常有效，且不良事件发生率可接受。在消融技术中，射频消融目前被视为一线选择，因为相关数据有力地支持了其疗效和安全性。然而，射频消融成本高昂，并非普遍可用，也不适用于每种情况。此外，原发性失败率和复发率也不容忽视。在过去几年中，冷冻治疗技术和混合氩离子凝固术越来越多地被评估为潜在的新型消融疗法。初步数据很有前景，表明它们甚至可能作为一线选择，替代射频消融。本综述的目的是为巴雷特食管的消融提供实用指南，重点关注不同的消融选择。
