Les techniques ablatives de l’œsophage de Barrett : quelles alternatives à la radiofréquence ? (notice n° 1673050)
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| control field | 20260301001054.0 |
| 041 ## - LANGUAGE CODE | |
| Language code of text/sound track or separate title | fre |
| 042 ## - AUTHENTICATION CODE | |
| Authentication code | dc |
| 100 10 - MAIN ENTRY--PERSONAL NAME | |
| Personal name | Barret, Maximilien |
| Relator term | author |
| 245 00 - TITLE STATEMENT | |
| Title | Les techniques ablatives de l’œsophage de Barrett : quelles alternatives à la radiofréquence ? |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. | |
| Date of publication, distribution, etc. | 2019.<br/> |
| 500 ## - GENERAL NOTE | |
| General note | 25 |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | After the endoscopic resection of an early neoplasia arising in Barrett's esophagus, eradication of intestinal metaplasia is recommended to prevent metachronous recurrence of esophageal neoplasia. Given the high stricture rates after extensive endoscopic resection for Barrett's esophagus, endoscopic ablative techniques are currently recommended. They include radiofrequency ablation, argon plasma coagulation, and cryoablation. The other indications for ablation are flat, high grade dysplasia, and more recently, low grade dysplastic Barrett's esophagus in selected patients with a high risk of neoplastic progression. The outcomes are good, with 90-92% eradication rates of intestinal metaplasia, but long-term follow-up data report 8% annual recurrence rate of intestinal metaplasia at the gastroesophageal junction, most of the time non dysplastic. Ablative techniques have an excellent safety profile, with virtually no early morbidity except from chest pain, and about 8% strictures. However, their use is limited by their high cost, the occurrence of buried metaplasia in up to 20% of patients, and the absence of histological assessment of the treated mucosa, requiring a minute endoscopic examination to rule out any visible lesion that would indicate endoscopic resection. Radiofrequency ablation is the most widely studied ablation technique, and currently the best to treat circumferential Barrett's esophagus. However, data on a new argon plasma coagulation device allowing for submucosal injection (Hybrid APC) and cryoablation are encouraging and make of these techniques acceptable alternatives to radiofrequency ablation. |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | Après résection endoscopique d’un cancer superficiel au sein d’un œsophage de Barrett, l’éradication de la métaplasie intestinale résiduelle est indiquée pour limiter le risque de néoplasie métachrone. Compte tenu des forts taux de sténose observés après résection endoscopique étendue, les techniques ablatives endoscopiques sont recommandées. Elles incluent l’ablation par radiofréquence, la coagulation au plasma argon, et la cryoablation. Leurs autres indications sont l’œsophage de Barrett en dysplasie de haut grade sans lésion visible, et depuis peu certains patients ayant un œsophage de Barrett en dysplasie de bas grade considéré à haut risque de progression néoplasique. Les résultats sont excellents, avec 90 % à 92 % de taux d’éradication de la métaplasie intestinale, mais des données de suivi à long terme suggèrent environ 8 % de taux de récidive annuelle, le plus souvent sous la forme de métaplasie intestinale du cardia non dysplasique. Ces techniques ont un excellent profil de tolérance, avec autour de 8 % de sténoses et pas de morbidité précoce en dehors de douleurs thoraciques. Cependant, outre leur coût élevé qui restreint leur utilisation, leurs limites sont la constitution de glandes métaplasiques enfouies après traitement atteignant selon les techniques jusqu’à 20 % des patients. De plus, l’analyse histologique du tissu traité n’est pas possible, imposant un examen préalable attentif afin de ne pas méconnaître une lésion visible qui imposerait une résection endoscopique première. Si la radiofréquence reste le dispositif le plus largement étudié dans la littérature, et le plus adapté à l’ablation de longs segments circonférentiels d’œsophage de Barrett, les données concernant le nouveau dispositif de coagulation au plasma argon après injection sous-muqueuse (Hybrid APC) et la cryoablation sont encourageantes, faisant de ces techniques des alternatives pertinentes à la radiofréquence. |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | cryoablation |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | dysplasie |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | endobrachyœsophage |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | œsophage de Barrett |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | plasma argon |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | radiofréquence |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | argon plasma coagulation |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | Barrett's esophagus |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | cryoablation |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | dysplasia |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | radiofrequency ablation |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Bordaçahar, Benoit |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Terris, Benoit |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Coriat, Romain |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Leblanc, Sarah |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Chaussade, Stanislas |
| Relator term | author |
| 786 0# - DATA SOURCE ENTRY | |
| Note | Hépato-Gastro & Oncologie Digestive | 26 | 1 | 2019-01-01 | p. 42-49 | 2115-3310 |
| 856 41 - ELECTRONIC LOCATION AND ACCESS | |
| Uniform Resource Identifier | <a href="https://stm.cairn.info/revue-hepato-gastro-et-oncologie-digestive-2019-1-page-42?lang=fr&redirect-ssocas=7080">https://stm.cairn.info/revue-hepato-gastro-et-oncologie-digestive-2019-1-page-42?lang=fr&redirect-ssocas=7080</a> |
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