Treatment of Barrett's esophagus with low-grade dysplasia using Hibrid-APC

Abstract

Introduction: Barrett's esophagus (BE) with low-grade dysplasia represents a risk of progression
towards esophageal adenocarcinoma. Hybrid-APC turns out to be an effective, safe, easy to use and
relatively low-cost technique to stop this progression. Aims: to describe the therapeutic response of
Hybrid-APC in patients with low-grade dysplasia in Barrett's esophagus. Method: an observational,
descriptive investigation of a series of cases was carried out at the National Center for Minimal Access
Surgery between December 2018 and December 2020. Twenty patients with BE histologically classified
with low-grade dysplasia were included. Ablation with Hybrid APC was applied, and endoscopy was
performed three and six months after the end of the treatment. The therapeutic response was evaluated
through histological remission and the presence of complications. The information was processed in the
statistical program SPSS, version 21. Results: mean age 50.5 (range 27-81 years). 55% (11) are male.
Eighty-five percent were asymptomatic and 90% had circumferential BE. 55% (11) required a Hybrid-
APC session. With an average of 1.4 sessions, macroscopic and histological remission without dysplasia
was achieved at three and six months in 90% (18/20) and 92.8% (13/14) of the patients respectively,
without witnessing complications. Conclusions: endoscopic treatment with the Hybrid-APC has a good
therapeutic response, with a good histological remission and without complications, in patients with
low-grade dysplasia in BE.