Short-term And Long-term Effects Of Endoscopic Argon Plasma Coagulation For The Treatment Of Barrett's Esophagus: A Prospective 3-year Follow-up

ObjectiveA prospective 3-year follow-up for the short-term and long-term effects of endoscopic argon plasma coagulation for the treatment of Barrett's esophagus is observed, and factors related to Barrett's esophagus recurrence are analyzed.Methods483 patients selected from Gastrointestinal Endoscopic Center of Tongji Hospital from 01/08/2006 to 31/03/2010 were diagnosed as BE by amplificatory chromoendoscopy and histopathological examination (292 cases were male and 191 cases were female). All patients were treated by APC at endoscopy, and then all of them received PPI therapy for 8 weeks. All patients received the amplificatory chromoendoscopy after 2 months, 6 months, 12 months, 18 months, 24 months, 30 months and 36 months to evaluate the therapeutic effect of APC for the treatment of BE.ResultsIn this study, lesions were completely disappeared in all patients after 2 months of argon plasma coagulation observed by amplificatory chromoendoscopy. There was no recurrence of lesions after treatment for 6 months. Then repeated amplificatory chromoendoscopy examination every 6 months was done until 36 months. Results showed that lesions began to relapse from the 12th after the treatment, and the relapse rate was gradually increased. The cumulative recurrence rate was 42.86% at 36th. The cases of adenocarcinoma of esophagus and serious complications related to treatment were not observed in all patients followed for 36 months. Lesions were disappeared after the second treatment in all relapse patients. There were significant differences in relapse rate in different gross types by amplificatory chromoendoscopy: the patients with island-type at endoscopy had lower relapse rate, the patients with mixed-type had higher relapse rate, and the relapse rate of patients with tongue-type was between both.ConclusionThe APC is an effective and safe treatment for BE patients. But it fails to prevent the relapse of lesions. The cumulative relapse rate is gradually increased after treatment with the follow-up from 12 months to 36 months, accordingly, the long-term follow-up of patients with BE after APC treatment is necessary. It is helpful to find relapse of lesions early and give related treatments in time, and improve the long-term prognosis of the disease.