GASTROENTEROLOGY ARTICLE OF THE WEEK
October 1, 2009
Sampliner, RE. Endoscopic therapy for Barrett’s esophagus. Clin Gastroenterol Hepatol 2009;7:716-720.
1. Techniques that have been used as ablation therapies for BE include
a. Multipolar electrocoagulation
b. Monopolar coagulation
c. Argon plasma coagulation
d. Sclerotherapy
e. Radio frequency ablation
f. Photodynamic therapy
g. Cryotherapy
2. Correct statements regarding neoplastic lesions in Barrett’s epithelium include
a. Patients with intramucosal adenocarcinoma have no risk of lymph node metastasis
b. A tumor that extends into the submucosa carries a nodal involvement risk of >15%
c. Patients with high grade dysplasia have no risk of node metastasis
d. In most cases, only HGD and intramucosal adenocarcinoma are eligible for endoscopic therapy
True or False
3. Patients with nodal involvement should undergo surgery to achieve cure
4. Results are equivalent for endoscopic therapy compared to surgery for high grade dysplasia
5. Strictures are less common with APC than PDT for Barrett’s epithelium ablation
6. Prospective randomized trials have shown a 77% clearance of intestinal metaplasia in patients treated with RFA
7. Nodal staging of adenocarcinoma is best achieved by high resolution CT scan examination
8. Non-dysplastic Barrett’s mucosa should be ablated to decrease risk of malignancy
9. EMR is preferred over other modalities for the treatment of mucosal irregularities (ie lumps and bumps)