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. 2018 Jun;6(5):678-683.
doi: 10.1177/2050640618758214. Epub 2018 Feb 5.

Non-thermal ablation of non-neoplastic Barrett's esophagus with the novel EndoRotor® resection device

Mate Knabe  1 , Sandra Blößer  1 , Jens Wetzka  1 , Christian Ell  1 , Andrea May  1
Affiliations

Non-thermal ablation of non-neoplastic Barrett's esophagus with the novel EndoRotor® resection device

Mate Knabe et al. United European Gastroenterol J. 2018 Jun.

Abstract

Background: International guidelines suggest endoscopic resection for all patients with low-risk mucosal cancer. Ultimately, it is essential to treat the remaining Barrett's esophagus as part of the treatment. Different thermal ablative therapies have been implemented to effect this treatment. They can lead to potential post-therapeutic stenosis. Furthermore, a histologic assessment of treated mucosa is not possible.

Objective: Clinical evaluation of a novel, non-thermal resection device (EndoRotor®) in the treatment of non-neoplastic Barrett's esophagus was conducted.

Methods: Fourteen patients with early Barrett's carcinoma were treated with endoscopic resection. Subsequently, EndoRotor® therapy was performed for resection of the remaining Barrett's mucosa. Complications were assessed during the study. After a three-month period patients received follow-up endoscopy to evaluate post-therapeutic stenosis.

Results: On average, 674 mm2 (172 mm2 - 1600 mm2) of Barrett's mucosa was treated with the novel device. In six (37.5%) cases, intra-procedural bleeding occurred with the need for hemostasis. All bleeding could be managed by endoscopic therapy alone. After a three-month follow-up there was no post-therapeutic stenosis registered.

Conclusion: EndoRotor® resection is a feasible non-thermal treatment of non-neoplastic Barrett's esophagus. Larger trials have to evaluate risks and benefits of this novel device.

Keywords: Barrett’s cancer; Esophageal cancer; ablation; adenocarcinoma; athermal; intestinal metaplasia.

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Figures

Figure 1.
Figure 1.
Endoscope with EndoRotor® catheter. At the tip of the probe there is a small window with a cutting blade for non-thermal resection.
Figure 2.
Figure 2.
The EndoRotor® resection system with suction device, probe and trap to collect the resection specimen.
Figure 3.
Figure 3.
Endoscopic view after saline injection and first cut. The EndoRotor® probe is clearly visible on the left-hand side.
Figure 4.
Figure 4.
Esophageal wound after ablation with the EndoRotor® system. At the base of the mucosal defect the intact circular muscle can be clearly seen with no clinically relevant bleeding.
See this image and copyright information in PMC

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