Endoscopy 2019; 51(04): S238
DOI: 10.1055/s-0039-1681884
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Esophagus ePosters
Georg Thieme Verlag KG Stuttgart · New York

HYBRID-APC FOR THE ENDOSCOPIC ERADICATION OF DYSPLASTIC BARRETT'S ESOPHAGUS IN A LOW PREVALENCE COUNTRY: LONG-TERM RESULTS OF THE TREATMENT AFTER THE ONSITE TRAINING

S Kashin
1   Endoscopy Department, Yaroslavl Regional Cancer Hospital, Yaroslavl, Russian Federation
,
N Vidyaeva
1   Endoscopy Department, Yaroslavl Regional Cancer Hospital, Yaroslavl, Russian Federation
,
R Kuvaev
1   Endoscopy Department, Yaroslavl Regional Cancer Hospital, Yaroslavl, Russian Federation
,
E Kraynova
2   Pathology Department, Yaroslavl Regional Cancer Hospital, Yaroslavl, Russian Federation
,
H Manner
3   Hendrik Manner, Frankfurt am Main, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

This study was undertaken to evaluate the efficacy and safety of Hybrid-APC for the treatment of dysplastic BE in a low prevalence country after the onsite training.

Methods:

All procedures were performed by a single operator (SK) after the onsite training by an experienced endoscopist (HM). Hybrid-APC was performed by the hybrid APC probe with water jet system (ERBE, Germany) in 5 steps: marking, submucosal injection, 1st mucosa ablation (60Watt), removal of tissue remnants by the distal cap, 2nd ablation with the lower power (40Watt). High dose PPI was administered after the procedures. After complete BE eradication endoscopy with 4-quadrant biopsies from former BE segment was performed in 3, 6 months and then annually. All histology specimens were estimated by an experienced gastrointestinal pathologist.

Results:

From 120 BE patients (registered from July 2014 to September 2017) 11 patients (5 male, 6 female, mean age 46 years (range 25 – 63)) were diagnosed with dysplasia and treated with Hybrid-APC. The mean length of BE was C1M2. In five cases EMR was performed for visible lesions before ablation. Eighteen Hybrid-APC sessions were successfully performed. Complete BE eradication was achieved after a mean of 1.6 (range 1 – 3) sessions. No perforation or uncontrollable bleeding was detected. Stricture formation was observed in one patient after combination therapy with Hybrid-APC and EMR in the one session and was managed by balloon dilatation. The patients were followed-up for a mean of 3.1 years (range 17 – 53 months) after BE eradication. Neither recurrence of intestinal metaplasia, nor buried intestinal metaplasia was seen in any patients.

Conclusions:

Our study demonstrated high effectiveness and safety of Hybrid-APC for treatment of dysplastic BE. 3-year follow-up didn't reveal any recurrence, buried metaplasia or any major complications. Since Hybrid-APC is an operator dependent technique our data emphasizes the importance of a proper training to provide reliable long-term outcomes.