Objective To formulate the treatment of Barrett esophagus and provide evidence-based solutions for doctors and patients. Methods We attempted to obtain evidence for treating Barrett esophagus by searching MEDLINE (1978 to 2005), CBMdisc (1978 to 2005) and The Cochrane Library (Issue 4, 2005). The quality of the retrieved evidence was evaluated. Results The therapies for Barrett esophagus include dietary intervention, change of life style, drug therapy, endoscopic therapy and surgery. We should choose different therapies according to the specific conditions of patients. Conclusions Endoscopic therapy has been developed a lot in recent years. The combination of two or more therapies may produce better effects.
Barrett’s esophagus is considered an important risk factor for the pathogenesis of esophageal adenocarcinoma. Treatment strategies for diseases from high-grade dysplasia （HGD） to adenocarcinoma are different. The recurrence rates of endoscopic treatment and anti-reflux surgery are comparatively higher. Abnormal lesions of the esophagus can be completely resected by esophagectomy for the treatment of HGD to adenocarcinoma, and treatment outcomes are confirmed.But appropriate surgical strategies and lymph node dissection scopes should be chosen according to different cancer staging.Lymph node metastasis is a major factor in determining prognosis.
Objective To make an individualized treatment plan for a newly diagnosed Barrett esophagus patient by means of evidence-based medicine. Methods After the clinical problems were put forward, both the systematic reviews and randomized controlled trials (RCTs) were collected from The Cochrane Library (Issue 3, 2009) and PubMed (1995 to 2010) and SCIE (1995 to 2010). The treatment protocol was made by combining the evidence and the preference of patient. Results A total of 21 RCTs and 6 systematic reviews (meta-analyses) were identified. A rational treatment plan was made upon a serious evaluation and patient’s preferences: improving the lifestyle and adopting the APC therapy combined with acid-suppressive drugs (Omeprazole, 40 mg, bid) for six weeks. Three months later, the endoscope reexamination showed the patient was much better. After another twelve-month follow-up, the plan proved to be optimal. Conclusion In accordance with the evidence-based methods, the rational treatment plan made for a diagnosed Barrett esophagus male can effectively relieve symptoms and improve quality of life.
目的:探讨内镜下氩离子凝固术(APC)联合抑酸治疗对Barrett食管的临床疗效。方法:选择经内镜及病理确诊的Barrett食管患者40例,随机分为两组,治疗组21例,对照组19例,治疗组经内镜下APC治疗后联合埃索美拉唑20mg 2次/日连续3月,对照组单用埃索美拉唑20mg 2次/日连续3月,分别于3月、6月、12月对两组进行临床症状积分和内镜及病理随访。结果:两组治疗后3、6、12月临床症状积分缓解无明显差异性(Plt;0.05),但从内镜、病理随访的有效率来看,治疗组与对照组相比有显著差异性(Plt;0.05)。结论:BE内镜下APC联合抑酸治疗能有效逆转Barrett上皮,是一种安全、有效的治疗方法。