Hybrid APC in Combination With Resection for the Endoscopic Treatment of Neoplastic Barrett's Esophagus: A Prospective, Multicenter Study.

"CONFLICTS OF INTEREST Guarantor of the article: Thomas Rösch, MD. Specific author contributions: Original data were collected in all participating centers in a central database. Data analysis was done by Hartmut Hahn/Erbe under the guidance of T.R. Manuscript writing was one by T.R. with input from all co-authors. S.S. contributed to the statistics. All authors had access to the study data and had reviewed and approved the final manuscript. Financial support: Study was supported by Erbe Co, Tübingen, Germany. Potential competing interests: None to report.Study HighlightsWHAT IS KNOWN✓ Neoplastic Barrett's esophagus (BE) is commonly treated by a combination of endoscopic resection of visible and/or cancerous lesions and ablation of the residual BE epithelium.✓ For ablation, thermal techniques are used in most cases, and of those, radiofrequency ablation is the technique with the most published evidence and is currently recommended.✓ Argon plasma coagulation (APC) has been used in some previous studies, with mixed results.WHAT IS NEW HERE✓ APC has been developed further into a new technique combining APC with prior submucosal injection, called hybrid argon plasma coagulation.✓ This is the first prospective multicenter series on 154 patients with a 2-year follow-up and a strict protocol, clearly differentiating initial and durable complete eradication of intestinal metaplasia including neoplasia.✓ Initial and durable success rates at 2 years in a per-protocol analysis were 87.2% and 70.8%, respectively.✓ Adverse events on a patient basis were seen in 6.1% including a stricture rate of 3.9% requiring a few dilatation sessions.✓ Final and solid evidence can only come from a randomized comparative trial."

"Financial support : Study was supported by Erbe Co, Tübingen, Germany."

"The study was performed prospectively in 9 gastroenterology/endoscopy centers in Germany (n = 7) and the Netherlands (n = 2). All centers had sufficient experience in interventional BE therapy (>100 patients with BE-N treated). The study protocol was approved by the Hamburg Chamber of Physicians (PV4583), followed by the local IRBs of participating centers. The study was registered with German Clinical Trials Register (DRKS-ID: DRKS00003369)."