Ablation of Barrett's epithelium by endoscopic argon plasma coagulation incombination with high-dose omeprazole

Background: Barrett's esophagus is a premalignant condition induced by gast roesophageal reflux, The aim of this prospective study was to assess the ef ficacy of argon plasma coagulation in combination with high-dose omeprazole therapy to ablate nondysplastic Barrett's epithelium. Methods: In 73 patients with histologically confirmed Barrett's epithelium, argon plasma coagulation was used in combination with maximal acid suppres sion (omeprazole 40 mg three times a day). Histologic and endoscopic change s were evaluated at 6- and 12-month intervals. Results: In 69 of 70 patients (98.6%) complete squamous regeneration was ac hieved after a median of 2 argon plasma coagulation sessions (range 1 to 5) . During a median follow-up of 12 months (range 2 to 51 months) there has b een no relapse or evidence of the development of dysplasia under continuous acid suppression,Three patients (4.3%) developed a mild stricture of the d istal esophagus that resolved after a single session of bougie dilation. Conclusions: In our experience, argon plasma coagulation in combination wit h high-dose omeprazole treatment is an effective and safe technique for com plete ablation of nondysplastic Barrett's epithelium. Restoration of squamo us mucosa after argon plasma coagulation appears to be long-lasting.