Title
Significance of nissen fundoplication after radiofrequency ablation for patients with Barrett's esophagus
Creator
Skrobić, Ognjan M., 1978-
Copyright date
2016
Object Links
Select license
Autorstvo-Nekomercijalno-Bez prerade 3.0 Srbija (CC BY-NC-ND 3.0)
License description
Dozvoljavate samo preuzimanje i distribuciju dela, ako/dok se pravilno naznačava ime autora, bez ikakvih promena dela i bez prava komercijalnog korišćenja dela. Ova licenca je najstroža CC licenca. Osnovni opis Licence: http://creativecommons.org/licenses/by-nc-nd/3.0/rs/deed.sr_LATN. Sadržaj ugovora u celini: http://creativecommons.org/licenses/by-nc-nd/3.0/rs/legalcode.sr-Latn
Language
English
Cobiss-ID
Committee report
Theses Type
Doktorska disertacija
description
Datum odbrane: 24.09.2016.
Other responsibilities
mentor
Peško, Predrag, 1955-
član komisije
Uglješić, Milenko, 1949-
član komisije
Simić, Aleksandar, 1965-
član komisije
Micev, Marjan, 1959-
član komisije
Bonavina, Luigi
član komisije
Riegler, Martin
Academic Expertise
Medicinske nauke
University
Univerzitet u Beogradu
Faculty
Medicinski fakultet
Alternative title
Značaj kombinovane radiofrekventne ablacije i antirefluksne hirurške procedure u lečenju bolesnika sa Barrett-ovim jednjakom
Publisher
[O. M. Skrobić]
Format
75 listova
description
Digestive diseases, Barrett’s esophagus / Digestivne bolesti, Barrett-ov jednjak
Abstract (en)
Barrett’s esophagus (BE) is a metaplastic condition where normal squamous
epithelium of the esophagus is replaced with columnar epithelium which contains
goblet cells. Radiofrequency endoscopic ablation (RFA) of BE is a relatively new
procedure, with already proven safety and efficacy profile, in the complete
eradication of BE (CR-IM). The aim of this study was to present our data regarding
the utilization of RFA in the treatment of metaplastic and dysplastic BE. The basic
goal was to evaluate the role of post RFA treatment in the term of BE recurrence
prevention. We also evaluated morphologic structure of neosquamous epithelium
(NSE) obtained from biopsy samples and processed on electron microscopy.
The data indicated that in patients with long segment BE and hiatal hernia>3 cm,
post RFA Nissen fundoplication has better protective effect than medical
treatment. The morphologic structure of NSE showed presence of dilated
intercellular spaces, which were present in higher extent in those patients who
were treated with medications.
To conclude, RFA procedure is safe and effective in the treatment of patients with
BE. In selected patients antireflux surgery may be offered as a standard treatment
due to its protective nature over NSE.
Abstract (sr)
Barrett-ov jednjak (BJ) predstavlja metaplaziju i nastaje kada se normalni
skvamocelularni epitel jednjaka transformiše u cilindrični epitel koji sadrži
peharaste ćelije. Radiofrekventna endoskopska ablacija (RFA) je relativno nova
procedura čija je bezbednost i efikasnost već dokazana u kompletnoj eradikaciji
Barrett-ovog jednjaka. Cilj ove studije bio je da se prikažu naši podaci u lečenju BJ
radiofrekventnom ablacijom jednjaka, a osnovi cilj studije bio je da se proceni
značaj primenjenog tretmana nakon RFA u smislu prevencije recidiva BJ. Takođe,
učinjena je evaluacija morfološke strukture neoskvamoznog epitela na osnovu
endoskopskih biopsija koje su obrađene i pregledane elektronskom
mikroskopijom.
Naši podaci su ukazali da bolesnici koji imaju duži segment BJ i hijatalnu herniju
>3 cm imaju manji stepen recidiva ukoliko je laparoskopska Nissen-ova
fundoplikacija načinjena nakon RFA u odnosu na one koji su dobijali
medikamentoznu terapiju. Analiza morfološke strukture neoskvamoznog epitela
ukazala je da u ovom epitelu postoje dilatirani međućelijski prostori , ali da su u
manjoj meri izraženi kod bolesnika koji su nakon RFA operisani.
U zaključku, RFA je sigurna i efikasna procedura u lečenju bolesnika sa BJ. U
određenoj grupi bolesnika antirefluksna hirurgija ima prednost kao standardni
tretman nakon uspešne ablacije u cilju prevecije recidiva oboljenja u odnosu na
medikamentoznu terapiju.
Authors Key words
Barrett’s esophagus, radiofrequency ablation, Nissen fundoplication,
proton pump inhibitors
Authors Key words
Barrett-ov jednjak, radiofrekventna ablacija, Nissen-ova
fundoplikacija, inhibitori protonske pumpe
Classification
616.329-006-089(043.3)
Type
Tekst
Abstract (en)
Barrett’s esophagus (BE) is a metaplastic condition where normal squamous
epithelium of the esophagus is replaced with columnar epithelium which contains
goblet cells. Radiofrequency endoscopic ablation (RFA) of BE is a relatively new
procedure, with already proven safety and efficacy profile, in the complete
eradication of BE (CR-IM). The aim of this study was to present our data regarding
the utilization of RFA in the treatment of metaplastic and dysplastic BE. The basic
goal was to evaluate the role of post RFA treatment in the term of BE recurrence
prevention. We also evaluated morphologic structure of neosquamous epithelium
(NSE) obtained from biopsy samples and processed on electron microscopy.
The data indicated that in patients with long segment BE and hiatal hernia>3 cm,
post RFA Nissen fundoplication has better protective effect than medical
treatment. The morphologic structure of NSE showed presence of dilated
intercellular spaces, which were present in higher extent in those patients who
were treated with medications.
To conclude, RFA procedure is safe and effective in the treatment of patients with
BE. In selected patients antireflux surgery may be offered as a standard treatment
due to its protective nature over NSE.
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