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Create a Free AccountProcedures - Ablation
Liquid nitrogen spray cryotherapy for intramucosal carcinoma and extensive gastric intestinal metaplasia with dysplasia
Gastric intestinal metaplasia with dysplasia (GIM-D) that is visible as a discrete limited lesion on endoscopy is readily treated using endoscopic mucosal resection or endoscopic submucosal dissection. However, there are few options for more extensive and invisible dysplasia. Ablating a wide swath of tissue with argon plasma coagulation or radiofrequency ablation can be challenging and carries risks, including postprocedure ulceration. Liquid nitrogen spray cryotherapy is an established treatment for dysplasia in Barrett’s esophagus, but its use for GIM-D has not been previously reported.Salvage circumferential endoscopic submucosal dissection for refractory dysplastic Barrett’s esophagus
A 64-year-old woman initially underwent endoscopy for reflux symptoms and was found to have C7M8 Barrett’s esophagus with biopsies demonstrating high-grade dysplasia. She was referred to a tertiary esophageal center, which performed endoscopic mucosa resection.Hybrid argon plasma coagulation: a new modality for treatment of a diffuse foregut anastomotic dysplastic lesion
Endoscopic management of a diffusely spreading adenomatous/dysplastic lesion at the site of a gastrojejunostomy (GJ) anastomosis can be challenging. EMR and endoscopic submucosal dissection (ESD) are technically difficult at such locations, and there is a risk of incomplete resection. We present a case of endoscopic management of such a lesion in an elderly patient using the novel hybrid argon plasma coagulation (APC) technology (Video 1, available online at www.VideoGIE.org ).
