Browsing by Author "Ivanović, Nenad (55375283100)"

Endoscopic radiofrequency ablation (RFA) today represents a well-established, safe and effective procedure for the treatment of Barrett's esophagus (BE). Choice of additional treatment to RFA emerges as an important clinical issue, due to the fact that recurrence of BE after complete eradication (CE) of intestinal metaplasia (IM) or dysplasia may occur. Concerning the data available so far, recurrence may occur due to insufficient reflux control with standard PPI's regimen, while those with large hiatal hernia and long segment BE represent the subgroup of patients at highest risk for recurrence. Due to the anatomical deviation in distal esophageal segment proper ablation may be difficult in such patients. These patients can be treated by employing concurrent ARS and RFA. Concurrent ARS and RFA was proven to be safe, not time consuming, and it can be performed in conjunction with the basic rules of RFA procedure. Early results, in term of enhanced healing of treated epithelium, and possible reduction in number of ablation sessions needed to achieve CE of IM or dysplasia, are promising. To conclude, antireflux surgery may have important role in some patients undergoing RFA, especially those with significant hiatal hernia and anatomical impairment in distal esophageal segment. © 2021 Annals of Esophagus.

Background: Achalasia is a primary esophageal motility disorder, predominantly presenting with dysphagia. With disease progression, the esophagus becomes tortuous and dilated, resulting in a condition known as “megaesophagus.” Tracheal compression with acute respiratory failure due to esophageal dilation is a rare but potentially fatal complication of achalasia. Case report: A 52-year-old male patient presented with acute respiratory failure and a history of prior dysphagia, regurgitation, and pneumonia. Further diagnostic tests revealed an extremely dilated esophagus compressing the trachea and lung parenchyma. Results: Laparoscopic Heller myotomy and fundoplication were performed, which alleviated the patient’s symptoms. Conclusion: Early recognition of this condition is crucial for patient survival, as is initial decompression of the dilated esophagus, relieving the patient of acute, life-threating symptoms. © The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature 2025.

Barrett's esophagus (BE) is a well established precursor of esophageal adenocarcinoma. Both, surveillance and therapeutic strategies have been proposed over the years. Recent deve-lopment of endoscopic radiofrequency ablation (RFA) brought new perspectives in the treatment of BE, with excellent initial results. The study of 40 pts with macroscopically visible BE on endoscopy and biopsy proven goblet cells presence, was conducted from January 2010 until March 2012. In all pts a complete symptomatic, endoscopic and manometric evaluation was performed. Initially RFA HALO 90 and 360 were performed in 28 and 12 pts respectively. Repeated treatments were conducted in 7 pts. The overall number was 50, while the mean number of RFA procedures per patient was 1.25. The mean circumferential length and maximal extent of BE were 1.61 and 3.29 cm respectively. We did not encounter esophageal perforation or hemorrhage during the procedure. Complications were transient short-term retrosternal pain (23 pts) and dysphagia (11 pts). Three months after the RFA mean values of cumulative symptom and heartburn score dropped significantly (p < 0.05). Functional diagnostics did not disclose any statistically significant decrease of lower esophageal sphincter pressure or esophageal body contraction amplitudes. One year foIlow-up was obtained in 26 pts and revealed a complete macroscopically visible BE eradication. So far, in 19 pts a laparoscopic Nissen fundoplication was performed up to 3 months after complete RFA BE eradication. HALO RFA procedure is safe and very effective in the treatment of pts with BE, does not lead to esophageal function impairment, and produces no long term and serious side effects.