| Barrettīs epithelium - therapeutic options |
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The left
photo shows an esophagus
during argon-plasma-beamer-
treatment. Since dysplastic cells with-
in a Barrettīs esophagus carry a considerable risk of malignant trans
formation ablative therapy is mandatory.
In case of a missing target for
mucosectomy we favour the shown treatmodality. On the right
picture additional methylenblue staining is used to better target the argon plasma beamer to
Barrett epithelum.
Literature
reports cases of persistent
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Barrettīs
epithelum beneath the subquently developping regenerative
epithelum.
The advantage
of mucosectomy following ligation is the
possibility of histologic work-up. Another
alternative for ablative therapy would be photodynamic
treatment.
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The left
photo shows the immediate result of the first treament.
Two weeks after
therapy there are still ulcers allaround the esophageal
wall, photo in the middle.
The same patient was reexamined after 6 weeks on the right
photo. Remaining Barrett epithelum
(finger- like epitheleal islands) warrants further argon
plasma beamer treatment.
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Barrett - therapy