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Barrett-Ösophagus: ablative Behandlungsmethoden

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Die intestinale Metaplasie im distalen Ösophagus wird als Folge einer langjährigen Refluxkrankheit angesehen. Dieses Barrett-Epithel birgt in Folge einer Dysplasie-Karzinom-Sequenz ein erhöhtes Risiko für ein Adenokarzinom der Speiseröhre. Zur Therapie stehen endoskopische Methoden auf dem Prüfstand, deren Vorteile gegenüber chirurgischen Verfahren in der geringeren Komplikationsrate und geringen Invasivität liegen. Die verschiedenen Formen der thermischen Ablation und die bisherigen Studienergebnisse werden in der folgenden Übersichtsarbeit vorgestellt. Dabei ist die Bewertung der verschiedenen Methoden besonders hinsichtlich des präventiven Einsatzes in Bezug auf das Adenokarzinom noch nicht vollständig abgeschlossen.

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Literatur

  1. Spechler SJ (2002) Barrett's esophagus. N Engl J Med 346: 836–842

    Google Scholar 

  2. Shaheen NJ, Crosby MA, Bozymski EM, Sandler RS (2000) Is there publication bias in the reporting of cancer risk in Barrett's esophagus? Gastroenterology 119: 333–338

    Google Scholar 

  3. Avidan B, Sonnenberg A, Schnell TG, Chejfec G, Metz A, Sontag SJ (2002) Hiatal hernia size, Barrett's length, and severity of acid reflux are all risk factors for esophageal adenocarcinoma. Am J Gastroenterol 97: 1930–1936

  4. Sampliner RE (2002) Updated guidelines for the diagnosis, surveillance, and therapy of Barrett's esophagus. Am J Gastroenterol 97: 1888–1895

    Google Scholar 

  5. Canto MI, Setrakian S, Willis J et al. (2001) Methylene blue staining of dysplasia and nondysplastic Barrett's esophagus. An in and ex vivo study. Endoscopy 33: 391–401

    Google Scholar 

  6. Schnell TG, Sontag SJ, Chejfec G et al. (2001) Long-term nonsurgical management of Barrett's esophagus with high grade dysplasia. Gastroenterology 120: 1607–1619

    Google Scholar 

  7. Peters FT, Ganesh S, Kuipers EJ, Sluiter WJ, Klinkenberg-Knol EC, Lamers CB, Kleibuker JH (1999) Endoscopic regression of Barrett's esophagus during omeprazole treatment: a randomized double blind study. Gut 45: 489–494

    Google Scholar 

  8. Malesci A, Savarino V, Zentilin P et al. (1996) Partial regression of Barrett's esophagus by long-term therapy with high-dose omeprazole. Gastrointest Endosc 44: 700–705

    Google Scholar 

  9. Ouatu-Lascar R, Triadafilopoulos G (1998) Complete elimination of reflux symptoms does not guarantee normalization of intraesophageal acid reflux in patients with Barrett's esophagus. Am J Gastroenterol 93: 711–716

    Google Scholar 

  10. Haag S, Nandukar S, Talley N (1999) Regression of Barrett's esophagus: the role of acid suppression, surgery, and ablative methods. Gastrointest Endosc 50: 229–240

    Google Scholar 

  11. Low DE, Levine DS, Dail DH, Kozarek RA (1999) Histological and anatomic changes in Barrett's esophagus after antireflux surgery. Am J Gastroenterol 94: 80–85

    Google Scholar 

  12. Sharma P Bhattacharyya A, Garewal HS, Sampliner RE (1999) Durability of new squamous epithelium after endoscopic reversal of Barrett's esophagus. Gastrointest Endosc 50: 159–164

    Google Scholar 

  13. Brand B, Porthun M, von Schrenck T et al. (2000) Endoscopic argonplasma coagulation for eradication of Barrett's epithelium. Zentralbl Chir 125: 437–442

    Google Scholar 

  14. Grade AJ, Shah IA Medlin SM, Ramirez FC (1999) The efficiacy and safety of argon plasma coagulation therapy in Barrett's esophagus. Gastrointest Endosc 50: 18–22

    Google Scholar 

  15. Michopoulos S, Tsibouris P, Bouzakis H, Sotiropoulou M, Kralios N (1999) Complete regression of Barrett's esophagus with heat probe thermocoagulation: mid-term results. Gastrointest Endosc 50: 165–172

    Google Scholar 

  16. Van Laethem JL, Cremer M, Peny MO, Delhaye M, Devière J (1998) Eradication of Barrett's mucosa with argon plasma coagulation and acid suppression: immediate and mid term results. Gut 43: 747–751

    Google Scholar 

  17. Schulz H, Michlke S, Antos D et al. (2000) Ablation of Barrett's epithelium by endoscopic argon plasma coagulation in combination with high dose omeprazole. Gastrointest Endosc 51: 659–663

    Google Scholar 

  18. Sampliner RE, Faigel D, Fennerty B, Lieberman D, Ippoliti A, Lewin K, Weinstein WM (2001) Effective and safe endoscopic reversal of nondysplastic Barrett's esophagus with thermal electrocoagulation combined with high-dose acid inhibition: a multicenter study. Gastrointest Endosc 53: 554–558

    Google Scholar 

  19. Bremner CG, Lynch VP, Ellis FH (1970) Barrett's esophagus: congenital or acquired? An experimental study of oesophageal mucosal regeneration in the dog. Surgery 68: 209–216

    Google Scholar 

  20. Byrne JP, Armstrong GR, Attwood SEA (1998) Restoration of the normal squamous lining in Barrett's esophagus by argon beam plasma coagulation. Am J Gastroenterol 93: 1810–1815

    Google Scholar 

  21. Van Laethem JL, Peny, MO, Salmon I, Cremer M, Devière J (2000) Intramucosal adenocarcinoma arising under squamous re-epithelialisation of Barrett's oesophagus. Gut 46: 574–577

    Google Scholar 

  22. Shand A, Dallal H, Palmer K, Ghosh S, MacIntyre M (2001) Adenocarcinoma arising in columnar lined oesophagus following treatment with argon plasma coagulation. Gut 48: 580–581

    Google Scholar 

  23. Van den Boogert J, van Hillegersberg R, Siersema PD, de Bruin RWF, Tilanus HW (1999) Endoscopic ablation therapy for Barrett's esophagus with high-grade dysplasia: a review. Am J Gastroenterol 94: 1153–1160

    Google Scholar 

  24. Overholt BF, Panjehpour M, Haydek JM (1999) Photodynamic therapy for Barrett's esophagus: follow-up in 100 patients. Gastrointest Endosc 49: 1–7

    Google Scholar 

  25. Gossner L, May A, Sroka R, Stolte M, Hahn EG, Ell C (1999) Photodynamic destruction of high grade dysplasia and early carcinoma of the esophagus after the oral administration of 5-aminolaevulinic acid. Cancer 86: 1921–1928

    Google Scholar 

  26. Sharma P, Jaffe PE, Bhattacharyya A, Sampliner RE (1999) Laser and multipolar electrocoagulation ablation of early Barrett's adenocarcinoma: long-term follow-up. Gastrointest Endosc 49: 442–446

    Google Scholar 

  27. Ackroyd R, Brown NJ, Davis MF et al. (2000) Photodynamic therapy for dysplastic Barrett's oesophagus: a prospective, double blind, randomised, placebo controlled trial. Gut 47: 612–617

    Google Scholar 

  28. Buttar NS, Wang KK, Lutzke LS, Krishnadath KK, Anderson MA (2001) Combined endoscopic mucosal resection and photodynamic therapy for esophageal neoplasia within Barrett's esophagus. Gastrointest Endosc 54: 682–688

    Google Scholar 

  29. Ell C, May A, Gossner L et al. (2000) Endoscopic mucosal resection of early cancer and high grade dysplasia in Barrett's esophagus. Gastroenterology 118: 670–677

    Google Scholar 

  30. Van Laethem JL, Jagododzinski R, Peny MO et al. (2001) Argon plasma coagulation in the treatment of Barrett's high grade dysplasia and in situ carcinoma. Endoscopy 33: 257–261

    Google Scholar 

  31. Gossner L, May A, Stolte M, Seitz G, Ell C (1999) KTP laser destruction of dysplasia and early cancer in columnar-lined Barrett's esophagus. Gastrointest Endosc 49: 8–12

    Google Scholar 

  32. May A, Gossner L, Günter E, Stolte M, Ell C (1999) Local treatment of early cancer in short Barrett's esophagus by means of argon plasma coagulation. Endoscopy 31: 497–500

    Google Scholar 

  33. May A, Gossner L, Günter E, Mayer G, Seitz G, Vieth M, Stolte M, Ell C (2002) Local endoscopic treatment for intraepithelial high-grade neoplasia and early cancer of Barrett's esophagus: Acute-phase and intermediate results of a new treatment approach. Eur J Gastroenterol Hepatol 14: 1085–1091

    Google Scholar 

  34. Stein HJ, Feith M, Mueller J, Werner M, Siewert JR (2000) Limited resection for early adenocarcinoma in Barrett's esophagus. Ann Surg 232: 732–742

    Google Scholar 

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Authors and Affiliations

  1. Innere Abteilung, St.-Hildegardis-Krankenhaus Mainz

    M. Jung

  2. II. Medizinische Klinik, Dr. Horst Schmitt-Kliniken (HSK) Wiesbaden

    C. Ell

  3. Innere Abteilung, St.-Hildegardis-Krankenhaus, Hildegardstraße 2, 55131, Mainz

    M. Jung

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Correspondence to M. Jung.

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Jung, M., Ell, C. Barrett-Ösophagus: ablative Behandlungsmethoden. Internist 44, 52–57 (2003). https://doi.org/10.1007/s00108-002-0809-0

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