Laparoscopic transgastric esophageal mucosal resection: 4-year minimum follow-up

Constantine T. Frantzides, Mark Alan Carlson, Ali Keshavarzian, Jacob E. Roberts

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: The management of high-grade esophageal dysplasia has included surveillance, endoscopic ablative techniques, and esophagectomy. Herein we describe an alternative treatment, laparoscopic transgastric esophageal mucosal resection. Methods: Laparoscopic transgastric esophageal mucosal resection was accomplished through an anterior gastrotomy. The mucosa was stripped from the Z-line to the proximal extent of the abnormal epithelium. The gastrotomy then was closed with a linear stapler, and a Nissen fundoplication was performed. Results: Six patients with high-grade dysplasia of the distal esophagus underwent mucosal resection. After 4 to 7 years of endoscopic surveillance, all patients have regenerated squamous epithelium. One patient developed nondysplastic Barrett's esophagus after 2 years and was treated medically. Two strictures were treated successfully with dilatation. Conclusions: Laparoscopic transgastric esophageal mucosal resection was a reasonable treatment for high-grade dysplasia in this small sample of patients. This technique is a potential alternative treatment for high-grade dysplasia of the esophagus.

Original languageEnglish (US)
Pages (from-to)305-307
Number of pages3
JournalAmerican journal of surgery
Volume200
Issue number2
DOIs
StatePublished - Aug 1 2010

Fingerprint

Esophagus
Epithelium
Fundoplication
Esophagectomy
Barrett Esophagus
Dilatation
Pathologic Constriction
Mucous Membrane
Therapeutics

Keywords

  • Barrett's esophagus
  • Esophageal adenocarcinoma
  • Gastroesophageal reflux disease
  • High-grade esophageal dysplasia
  • Minimally invasive surgery
  • Mucosal ablation

ASJC Scopus subject areas

  • Surgery

Cite this

Laparoscopic transgastric esophageal mucosal resection : 4-year minimum follow-up. / Frantzides, Constantine T.; Carlson, Mark Alan; Keshavarzian, Ali; Roberts, Jacob E.

In: American journal of surgery, Vol. 200, No. 2, 01.08.2010, p. 305-307.

Research output: Contribution to journalArticle

Frantzides, Constantine T. ; Carlson, Mark Alan ; Keshavarzian, Ali ; Roberts, Jacob E. / Laparoscopic transgastric esophageal mucosal resection : 4-year minimum follow-up. In: American journal of surgery. 2010 ; Vol. 200, No. 2. pp. 305-307.
@article{2098e906323749ccba99f7a8d4cb7d13,
title = "Laparoscopic transgastric esophageal mucosal resection: 4-year minimum follow-up",
abstract = "Background: The management of high-grade esophageal dysplasia has included surveillance, endoscopic ablative techniques, and esophagectomy. Herein we describe an alternative treatment, laparoscopic transgastric esophageal mucosal resection. Methods: Laparoscopic transgastric esophageal mucosal resection was accomplished through an anterior gastrotomy. The mucosa was stripped from the Z-line to the proximal extent of the abnormal epithelium. The gastrotomy then was closed with a linear stapler, and a Nissen fundoplication was performed. Results: Six patients with high-grade dysplasia of the distal esophagus underwent mucosal resection. After 4 to 7 years of endoscopic surveillance, all patients have regenerated squamous epithelium. One patient developed nondysplastic Barrett's esophagus after 2 years and was treated medically. Two strictures were treated successfully with dilatation. Conclusions: Laparoscopic transgastric esophageal mucosal resection was a reasonable treatment for high-grade dysplasia in this small sample of patients. This technique is a potential alternative treatment for high-grade dysplasia of the esophagus.",
keywords = "Barrett's esophagus, Esophageal adenocarcinoma, Gastroesophageal reflux disease, High-grade esophageal dysplasia, Minimally invasive surgery, Mucosal ablation",
author = "Frantzides, {Constantine T.} and Carlson, {Mark Alan} and Ali Keshavarzian and Roberts, {Jacob E.}",
year = "2010",
month = "8",
day = "1",
doi = "10.1016/j.amjsurg.2009.10.011",
language = "English (US)",
volume = "200",
pages = "305--307",
journal = "American Journal of Surgery",
issn = "0002-9610",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Laparoscopic transgastric esophageal mucosal resection

T2 - 4-year minimum follow-up

AU - Frantzides, Constantine T.

AU - Carlson, Mark Alan

AU - Keshavarzian, Ali

AU - Roberts, Jacob E.

PY - 2010/8/1

Y1 - 2010/8/1

N2 - Background: The management of high-grade esophageal dysplasia has included surveillance, endoscopic ablative techniques, and esophagectomy. Herein we describe an alternative treatment, laparoscopic transgastric esophageal mucosal resection. Methods: Laparoscopic transgastric esophageal mucosal resection was accomplished through an anterior gastrotomy. The mucosa was stripped from the Z-line to the proximal extent of the abnormal epithelium. The gastrotomy then was closed with a linear stapler, and a Nissen fundoplication was performed. Results: Six patients with high-grade dysplasia of the distal esophagus underwent mucosal resection. After 4 to 7 years of endoscopic surveillance, all patients have regenerated squamous epithelium. One patient developed nondysplastic Barrett's esophagus after 2 years and was treated medically. Two strictures were treated successfully with dilatation. Conclusions: Laparoscopic transgastric esophageal mucosal resection was a reasonable treatment for high-grade dysplasia in this small sample of patients. This technique is a potential alternative treatment for high-grade dysplasia of the esophagus.

AB - Background: The management of high-grade esophageal dysplasia has included surveillance, endoscopic ablative techniques, and esophagectomy. Herein we describe an alternative treatment, laparoscopic transgastric esophageal mucosal resection. Methods: Laparoscopic transgastric esophageal mucosal resection was accomplished through an anterior gastrotomy. The mucosa was stripped from the Z-line to the proximal extent of the abnormal epithelium. The gastrotomy then was closed with a linear stapler, and a Nissen fundoplication was performed. Results: Six patients with high-grade dysplasia of the distal esophagus underwent mucosal resection. After 4 to 7 years of endoscopic surveillance, all patients have regenerated squamous epithelium. One patient developed nondysplastic Barrett's esophagus after 2 years and was treated medically. Two strictures were treated successfully with dilatation. Conclusions: Laparoscopic transgastric esophageal mucosal resection was a reasonable treatment for high-grade dysplasia in this small sample of patients. This technique is a potential alternative treatment for high-grade dysplasia of the esophagus.

KW - Barrett's esophagus

KW - Esophageal adenocarcinoma

KW - Gastroesophageal reflux disease

KW - High-grade esophageal dysplasia

KW - Minimally invasive surgery

KW - Mucosal ablation

UR - http://www.scopus.com/inward/record.url?scp=77955901781&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77955901781&partnerID=8YFLogxK

U2 - 10.1016/j.amjsurg.2009.10.011

DO - 10.1016/j.amjsurg.2009.10.011

M3 - Article

C2 - 20188346

AN - SCOPUS:77955901781

VL - 200

SP - 305

EP - 307

JO - American Journal of Surgery

JF - American Journal of Surgery

SN - 0002-9610

IS - 2

ER -