الفهرس 
GASTROESOPHAGEALOnly 14 pages are availabe for public view
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Abstract
arrett’s Esophagus (BE) is a well recognized complication of Gastro-Esophageal Reflux Disease (GERD).Prolonged exposure of the esophagus to the refluxate can erode the esophageal mucosa, promote inflammatory cell infiltrate, and ultimately cause epithelial necrosis. This chronic damage is believed to promote the replacement of healthy esophageal epithelium with the metaplastic intestinal columnar cells (Poyer, 2006)
The prevalence of BE in the United States is 376 cases per 100,000 population and internationally, probably parallels that in the United States (Cameron, 1997)
Treatment for BE has been consisted of medical treatment (acid suppression medications), surgery (fundoplication) and endoscopic ablative techniques, (Faybush and Sampliner, 2005).
This study was conducted at the GIT Endoscopy Unit at Al Bakry Hospital from Jan. 2007 to Dec. 2009. Patients (22) ,whose diagnosed endoscopically and histologically as having BE and showing low grade dysplasia, were divided into two groups to undergo ablation with EMR or APC and a follow up sessions every 4-8 weeks until there was Endoscopic reversal or a maximal of three treatment sessions. All patients were under treatment with Omeprazole 20 mg twice a day.
Our results revealed that complete reversal was documented in 17 patients from all the 22 patients treated (77.3%). EMR was superior on APC in success rate. BE was successfully ablated in 10 of 11 patients (90.9%) treated with EMR and in 7 of 11 patients (63.8%) treated with APC. Despite the greater number of sessions done on the APC limb, it fails to improve the success rate. The total number of endoscopic sessions required in the EMR group was 27 sessions with a mean number of 2.5 ranging from 2-3 sessions to each patient but total number of endoscopic sessions required in the APC group was 32 sessions with a mean number of 2.9 ranging from 1-3 sessions to each patient.
We can say that there was no effect of age on the success rate. That was obvious on the APC limb (success mean age= 36.4, failed mean age= 34.5). On the EMR limb, despite the age of failed patients was less than the successful patients, the small number of failed patients (only one case) cannot support this concept.
Sex has no effect on the results, the male and female gave more or less similar results.
There was a significant relation between grading of GERD and net results. The best success was in grade (A) and the worthiest in grade (C).
HH had no significant effect on the net results, Also, gastritis found to be innocent from any effect on the failure of ablative therapy.