Ragunath, K.; Krasner, N.; Raman, V.S.; Haqqani, M.T.; Cheung, W.Y.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA42
Academic Journal
Background: A number of thermal and non-thermal modalities have been applied in an effort to eradicate dysplasia and reverse the Barrett's epithelium. Quality of life (QOL) assessment is an important outcome measure, since these interventions result in procedure related morbidity. Aim: To assess QOL measurement in a cohort of patients with dysplastic Barrett's oesophagus undergoing two different endoscopic mucosal ablation modalities as part of a randomised clinical trial. Methods: Twenty-nine patients with dysplastic Barrett's oesophagus underwent mucosal ablation: Photodynamic therapy (PDT) with Photofrin was performed in one session-13 patients and Argon Plasma Coagulation (APC) was performed in 1-6 (mean 3) sessions-16 patients. Treatment and disease specific QOL questionnaire was constructed based on previous validated Gastrointestinal QOL tool. A 10-item questionnaire was constructed with 5 responses in each question. Most desirable option: 5 points, and least desirable option: 1 point (maximum: 50, minimum: 10). Patients were asked to fill the questionnaire immediately before the procedure and 2 weeks after the procedure (in the case of APC after the first session). The scores before and after treatment were compared using the paired t test and the difference between the two treatment groups was analysed using the unpaired t test. Results: All but 3 patients in the APC group completed the study. In the PDT group the mean pre-treatment QOL score was 45 and post treatment QOL score was 39, p=0.0002 (95% CI 3.54-8.76). In the APC group the mean pre-treatment score was 39 and post-treatment score was 33, p=0.0008 (95% CI 2.80-8.27). There was no significant difference in QOL pre and post-treatment between the two groups. Conclusion: QOL is significantly affected in patients undergoing endoscopic mucosal ablation therapy for at least 2 weeks following the procedure. Future studies comparing various endoscopic mucosal ablation modalities should assess QOL as...


Related Articles

  • ZOOM CHROMOENDOSCOPY TO DETECT DYSPLASIA IN BARRETT'S OESOPHAGUS. Raman, V. S.; Krasner, N.; Ragunath, K.; Haqqani, M. // Gut;Apr2004 Supplement 3, Vol. 53, pA58 

    Dysplasia within Barrett's epithelium (BE) is the most practical marker for potential progression to cancer. Targeted biopsy using Zoom endoscopy may provide better yield for dysplasia. The study was conducted to examine the utility of methylene blue chromoendoscopy (MBC) with a high resolution...

  • Dysplasia in Barrett's Esophagus: Limitations of Current Management Strategies. Spechler, Stuart Jon // American Journal of Gastroenterology;Apr2005, Vol. 100 Issue 4, p927 

    Dysplasia is a very imperfect biomarker for malignancy in Barrett's esophagus. Invasive cancer has been found in 30–40% of esophagi resected because preoperative endoscopic examinations had shown high-grade dysplasia. Reports on the natural history of this disorder are sometimes...

  • Barrett’s high-grade dysplasia: wait and watch?1,2 1Schnell TG, Sontag SJ, Cheifec G, et al. Long-term Nonsurgical Management of Barrett’s Esophagus With High-Grade Dysplasia Gastroenterology 2001;120:1607–1619 2Editor: David Johnson, MD., F.A.C.G. George, Sabu J.; Sharma, Prateek // American Journal of Gastroenterology;Oct2002, Vol. 97 Issue 10, p2674 

    In this study, Schnell and colleagues at the Hines VA in Illinois, report their experience in patients with Barrett’s high-grade dysplasia. Over a 20-year period, 1099 patients were diagnosed with Barrett’s esophagus including 79 patients (7.1%) with high-grade dysplasia (HGD)....

  • EXPRESSION ANALYSIS OF THE METAPLASIA DYSPLASIA CARCINOMA SEQUENCE IN BARRETT'S OESOPHAGUS AND ADENOCARCINOMA. Penman, I.D.; Smith, V.; Shen, E.F.; Wieand, D.; Landon, T.H.; Wong, N.A.C.S.; Lessells, A.M.; Paterson-Brown, S.; Tang, J.Z.; Wu, T.; Hillan, K.J. // Gut;Apr2003 Supplement 1, Vol. 52, pA7 

    Introduction and Aims: The molecular genetic events involved in the metaplasia dysplasia carcinoma (MDC) sequence in Barrett's oesophagus (CLO) are incompletely understood. We applied microarray expression analysis of endoscopic biopsies to study further these events and to detect novel genes...

  • Transitional Cell Carcinoma Arising in the Gastric Remnant Following Gastrocystoplasty. Hinghui Qiu; Kordunskaya, Svetlana; Yantiss, Rhonda K. // International Journal of Surgical Pathology;Apr2003, Vol. 11 Issue 2, p143 

    Examines the transitional cell carcinoma (TCC) arising in the gastric remnant following gastrocytoplasty, described in the case of a 73-year-old woman who developed a TCC associated with transitional cell metaplasia and dysplasia of the gastric epithelium. Risk of patients for the development...

  • Endoscopic approach to the diagnosis of fibrous dysplasia. Isenberg, Steven F. // ENT: Ear, Nose & Throat Journal;Dec1994, Vol. 73 Issue 12, p926 

    Discusses an endoscopic approach to the diagnosis of fibrous dysplasia. Case history of 15-year-old suffering from severe headaches; Resolution of pneumoencephalus through computerized tomography of brain; Symptoms and characteristics of fibrous dysplasis; Treatment; Advantages of intranasal...

  • Endoscopy II.  // Gut;Jul2012 Supplement, Vol. 61, pA267 

    The article presents abstracts on medical topics of Great Britain which include the cost of baristric surgery for endoscopy, indications of colonoscopy and the detection of dysplasia in Barrett's oesophagus.

  • Long-term Follow-up of Barrett's High-Grade Dysplasia. Weston, Allan P.; Sharma, Prateek; Topalovski, Margaretia; Richards, Robert; Cherian, Rachel; Dixon, Anita // American Journal of Gastroenterology;Aug2000, Vol. 95 Issue 8, p1888 

    OBJECTIVE: The management of Barrett's high-grade dysplasia (HGD) remains controversial. The aims of this study were to evaluate prospectively the outcome of unifocal HGD (uHGD) in patients with Barrett's esophagus, and to determine demographic and endoscopic features predictive of progression...

  • Prostaglandin-Stimulated Recovery of the Human Duodenal Epithelium: Effects of Misoprostol on Ethanol Damage. Foschi, D.; Marazzi, M.; Toti, G. L.; Radaelli, E.; Ferrante, F.; Vaiani, G.; Galeone, M.; Trabucchi, E. // American Journal of Gastroenterology;Nov1990, Vol. 85 Issue 11, p1498 

    This study was designed to determine whether prostaglandins can stimulate the repair of human duodenal epithelium. Ten healthy volunteers were given 50 ml 40% ethanol through an endoscope onto the duodenal mucosa 1-7 cm from the pyloric sphincter; 3 min later, misoprostol (200 µg) or inert...


Read the Article


Sign out of this library

Other Topics