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Early esophageal neoplasia: etiology, pathophysiology, pathogenesis and treatment. Barrett's esophagus and early esophageal adenocarcinoma
Krajčíová, Jana ; Martínek, Jan (advisor) ; Dolina, Jiří (referee) ; Bureš, Jan (referee)
Background: Barrett's esophagus (BE) is a premalignant condition defined by replacement of normal esophageal squamous-cell epithelium by cylindrical epithelium with intestinal metaplasia (IM). Patients with BE associated neoplasia (BORN) are candidates for endoscopic treatment. The aims of our studies were: (1) analysis of long-term efficacy of radiofrequency ablation (RFA) and evaluation of risk factors for persistent/ recurrent neoplasia/ IM; (2) to assess the results and safety of confocal laser endomicroscopy (CLE) compared to standard biopsies in patients after successful endoscopic treatment of BORN; (3) to assess the sampling quality obtained by different types of forceps; and (4) to assess "de novo" reflux after peroral endoscopic myotomy (POEM) and its severity (the risk of development of further complications). Patients and methods: We performed a total of 4 studies. (1) In a retrospective RFA study we evaluated data of 136 patients treated endoscopically for BORN in 4 centers in the Czech Republic. (2) In a prospective, pathologist-blinded, CLE study, we evaluated concordance in the detection of IM or neoplasia with CLE compared to standard biopsies in 56 patients who underwent standard surveillance endoscopy. (3) In a prospective study comparing 4 types of forceps, we evaluated the...

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