ArticleGastroenterology2012
Increased risk for persistent intestinal metaplasia in patients with Barrett's esophagus and uncontrolled reflux exposure before radiofrequency ablation.
Article in Gastroenterology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it, 112 citations in OpenAlex.
- AGA Clinical Practice Guideline on Endoscopic Eradication Therapy of Barrett's Esophagus and Related Neoplasia.Gastroenterology · 2024Guideline
- Efficacy and durability of radiofrequency ablation for Barrett's Esophagus: systematic review and meta-analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2013Pooled it
- Endoscopic Therapy in Barrett's Esophagus.Visceral medicine · 2026Article
- Clinical significance of hiatus hernia on Barrett's oesophagus: a scoping review.Langenbeck's archives of surgery · 2026Article
- Review
- Applications of cryotherapy in premalignant and malignant esophageal disease: Preventing, treating, palliating disease and enhancing immunogenicity?World journal of gastrointestinal oncology · 2025Review
- Impact of post RFA treatment on neosquamous epithelium microstructure.Scientific reports · 2024Observational
- Novel histologic score predicts recurrent intestinal metaplasia after successful endoscopic eradication therapy.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2023Article
- Seeking to understand non-responders to ablative therapy for dysplastic Barrett's esophagus.Clinical endoscopy · 2023Article
- Clinical and pathological predictors of failure of endoscopic therapy for Barrett's related high-grade dysplasia and early esophageal adenocarcinoma.Surgical endoscopy · 2021Article
- Hiatal Hernia Associated with Higher Odds of Dysplasia in Patients with Barrett's Esophagus.Digestive diseases and sciences · 2021Article
- Cryoballoon ablation for treatment of patients with refractory esophageal neoplasia after first line endoscopic eradication therapy.Endoscopy international open · 2020Article
- Management of Barrett's esophagus with dysplasia refractory to radiofrequency ablation.World journal of gastroenterology · 2020Review
- Challenges in Endoscopic Therapy of Dysplastic Barrett's Esophagus.Current treatment options in gastroenterology · 2019Review
- Length of Barrett's segment predicts failure of eradication in radiofrequency ablation for Barrett's esophagus: a retrospective cohort study.BMC gastroenterology · 2018Article
- Precision care for Barrett's esophagus.Translational gastroenterology and hepatology · 2018Review
- Ductular and proliferative response of esophageal submucosal glands in a porcine model of esophageal injury and repair.American journal of physiology. Gastrointestinal and liver physiology · 2017Article
- Advances in the Diagnosis and Treatment of Barrett's Esophagus and Early Esophageal Cancer; Summary of the Kelly and Carlos Pellegrini SSAT/SAGES Luncheon Symposium.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2017Review
- Development of Quality Indicators for Endoscopic Eradication Therapies in Barrett's Esophagus: The TREAT-BE (Treatment With Resection and Endoscopic Ablation Techniques for Barrett's Esophagus) Consortium.The American journal of gastroenterology · 2017Review
- Quality Indicators in Endoscopic Ablation for Barrett's Esophagus.Current treatment options in gastroenterology · 2017Review
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND &
aimsRadiofrequency ablation (RFA) is a safe alternative to esophagectomy for patients with dysplastic Barrett's esophagus (BE). Although some studies have indicated that RFA is effective at eradicating dysplasia, most have found that RFA is not as effective in eradicating intestinal metaplasia. We investigated whether uncontrolled reflux is associated with persistent intestinal metaplasia after RFA.
methodsThirty-seven patients with BE underwent RFA, high-resolution manometry, and 24-hour impedance-pH testing; they received proton pump inhibitors twice daily. Patients returned every 2 months for repeat treatment or standard surveillance. Patients were classified as complete responders (CRs) if all intestinal metaplasia was eradicated in fewer than 3 ablation sessions. We analyzed clinical parameters to identify factors associated with a CR or incomplete responder (ICR).
resultsAmong the 37 patients, 22 had a CR and 15 had an ICR. Mann-Whitney U tests revealed that length of BE, size of hiatal hernia, and frequency of reflux, but not acid reflux, differed between CRs and ICRs. CRs had fewer weakly acidic events than ICRs (29.5 vs 52; P < .05) and total reflux events (33.5 vs 60; P < .05), and a trend toward fewer weakly alkaline events (1.0 vs 5.0; P = .06). No other clinical or manometric features differed between groups.
conclusionsUncontrolled, predominantly weakly acidic reflux despite twice-daily proton pump inhibitor therapy before RFA increases the incidence of persistent intestinal metaplasia after ablation in patients with BE. Length of BE and size of hiatal hernia also were associated with persistent intestinal metaplasia after RFA.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.