5-Year Follow-up of Patients After Hybrid-Apc of Barrett’s Esophagus With Dysplasia: Case-Series Results

Aims The purpose of present study was to evaluate long-term efficacy and safety of new Hybrid-APC therapy for dysplastic Barrett’s esophagus (BE) after onsite training.

Methods Therapeutic procedures were performed by single operator after onsite training by experienced in Hybrid-APC endoscopist. During that training was developed standardized protocol, according to which Hybrid-APC has to be carried out by hybrid-APC probe with waterjet system (ERBE, Germany) as 5-step procedure: marking, submucosal injection, 1^st mucosa ablation (60 Watt), removal of tissue remnants, 2^nd ablation (40Watt). Endoscopic surveillance with 4-quadrant biopsies from former BE segment was performed in 3, 6 months and then annually. An experienced gastrointestinal pathologist assessed biopsy specimens.

Results 11 patients with dysplastic BE (5 male and 6 female, mean age 46 years (range 25 – 63)) were treated with Hybrid-APC from July 2014 to September 2017. The mean BE length was C1M2. 5 EMRs of visible lesions and 18 Hybrid-APC sessions were successfully performed. Complete BE eradication was achieved in all patients after a mean of 1.6 (range 1-3) ablation sessions. There was one treatment-related stricture (9.1 %) after Hybrid-APC combined with EMR in same session; it was managed by balloon dilatation. Patients were followed-up for a mean of 4,9 years (range 41-77 months) after complete BE eradication. Recurrence of metaplasia or dysplasia was not seen in any patient. We took 274 biopsy samples, 36 of them (13.1 %) contained subepithelial lamina propria. Buried intestinal metaplasia or dysplasia was not found in any biopsies specimens.

Conclusions According to this case-series study, Hybrid-APC was effective and safe method for treatment of dysplastic BE. During 5-year follow-up there were not any recurrences of intestinal metaplasia and dysplasia or any serious complications. Since Hybrid-APC is highly operator dependent technique our data emphasizes importance of proper training and adherence to standardized treatment and surveillance protocol to provide good long-term results.

Citation: Kashin S, Vidyaeva N, Kuvaev R et al. eP22 5-YEAR FOLLOW-UP OF PATIENTS AFTER HYBRID-APC OF BARRETT’S ESOPHAGUS WITH DYSPLASIA: CASE-SERIES RESULTS. Endoscopy 2021; 53: S104.

Publication History

Article published online:
19 March 2021