633P - Endoscopic resection for Barrett's esophagus: Uzbekistan experience

Abstract

Background: In the treatment of esophageal dysplasia, particularly Barrett's esophagus, radical endoscopic resection (SRER) has shown its effectiveness. The purpose of this study was to evaluate the long-term results of treatment of Barrett's esophagus dysplasia after a successful SRER. Methods: Patients who received SRER for BE ≤ 5 cm with high-grade dysplasia (HGD) or early cancer (EC) achieved complete elimination of intestinal metaplasia (CE-IM) and neoplasia (CE-neo). Primary outcomes: relapse of neoplasia (HGD/EC), recurrence of dysplasia (including indefinite dysplasia) and recurrence of endoscopically visible BE. METHODS: Patients who received SRER for BE ≤ 5 cm with high-grade dysplasia (HGD) or early cancer (EC) achieved complete elimination of intestinal metaplasia (CE-IM) and neoplasia (CE-neo). Primary outcomes: relapse of neoplasia (HGD/EC), recurrence of dysplasia (including indefinite dysplasia) and recurrence of endoscopically visible BE. Results: Hidden Barrett's glands, IM in biopsy specimens obtained distal to the normal emerging neo-squamocolumnar compound, the need for re-treatment, and sustained by CE-IM and CE-neo at the last follow-up endoscopy. RESULTS: 76 patients were included (65 men, mean age 66 years, median BE C2M3). The median follow-up was 76 months. A repetition of neoplasia was observed in 1 patient (T1bN0M0) after 130 months of observation and was treated with medical surgery (annual frequency 0.22% per year of the patient's observation). Four patients had recurrent dysplasia (0.87% per patient-year of follow-up). Twelve patients had recurrent endoscopically visible BE after median follow-up for 22 months (2.6% for each subsequent patient-year of observation), mostly small islands or languages. Five patients were found to have one Barrett burial gland finding (1.1% per year of the patient's observation), and 27 patients (5.9% per year of the patient's observation) showed MI in biopsies only distal to the neo-squamocolumnar junction was not reproduced in 56%. Repeated treatment was performed in 9 patients. CE-IM and CE-neo (excluding IM in the neon-squamolecular compound) in the last endoscopic endoscopy were seen in 95% and 97% of patients, respectively. Conclusions: This study presents the longest published data on SRER to date. 6-year results show that a successful SRER is a long-term therapy for BE ≤ 5 cm with HGD/EC. Legal entity responsible for the study: Tashkent Medical Academy Funding: None Disclosure: All authors have declared no conflicts of interest.