Atlas of Gastroenterological Endoscopy
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Barrettīs epithelium - therapeutic options
Argonplasma coagulation 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 Argonplasma coagulation
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.
Immediatly after Argonplasma coagulation 2 weeks after Argonplasma coagulation 6 weeks after Argonplasma coagulation
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.