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Acta médica Grupo Ángeles
Print version ISSN 1870-7203
Abstract
GALVEZ VALDOVINOS, Ramiro et al. Effectiveness of the endoscopic mucosectomy versus argon plasma in patients with Barrett’s esophagus and low-grade dysplasia. Acta méd. Grupo Ángeles [online]. 2019, vol.17, n.1, pp.19-24. Epub May 11, 2021. ISSN 1870-7203.
Introduction and objective: The evolution of Barrett’s esophagus is to low (NIBG) or high grade intraepithelial neoplasia. To compare endoscopic mucosectomy versus argon ablation of Barrett’s esophagus (EB) with low grade intraepithelial neoplasia.
Material and methods:
In a prospective, randomized, and comparative study of 20 patients with EB and NIBG, two groups were formed; group I: ten with endoscopic mucosectomy; group II: ten with argon plasma ablation. Nissen 360o fundoplication was performed, with three and five-year controls with biopsies. Fisher exact test was used.
Results:
20 patients with mean age of 49 years and EB and NIBG, 15 males, all with GERD, with pH monitoring/24 hours less than 3.3. The histopathological results of the mucosectomy were: seven patients with EB and NIBG; one patient with in situ carcinoma and two patients with high grade intraepithelial neoplasia. In the three and five-year follow-up, nine patients in group I were endoscopically normal (p = 0.04); in group II, the follow-up at three and five years showed persistence of EB in nine cases, without dyplasia (p = 0.3).
Conclusions:
Endoscopic mucosectomy eliminated EB and NIBG, whereas plasma argon ablation eliminated NIBG in nine of 10 cases, with EB persisting.
Keywords : Barrett’s esophagus; low grade dysplasia; mucosectomy; argon plasma ablation.
