Ablation of nonneoplastic Barrett's mucosa using argon plasma coagulation with concomitant esomeprazole therapy (APBANEX): a prospective multicenter evaluation

Am J Gastroenterol. 2006 Aug;101(8):1762-9. doi: 10.1111/j.1572-0241.2006.00709.x. Epub 2006 Jun 30.


Background: Complete reversal of Barrett's epithelium (BE) achieved by treatment with argon plasma coagulation (APC) is variable. The aim of this prospective study was to evaluate the effectiveness of high-power APC in a multicenter trial.

Methods: In seven study centers, 60 patients (mean age 57, range 27-77) with nonneoplastic BE (length 1-8 cm) were recruited for treatment with high-power APC (90 W) in combination with esomeprazole 80 mg/day. Video endoscopy, chromoendoscopy, and four-quadrant biopsies (4QB) were carried out during baseline endoscopy and regular intervals. The effect of ablation was classified as complete remission (CR), partial remission, or minor response.

Results: Fifty-one of the 60 patients completed ablation therapy. Three patients were lost to follow-up (FU). After a mean of 2.6 APC sessions (range 1-5) and a mean FU of 14 months (range 12-32), CR was achieved in 37 of 48 patients (77%). Major complications occurred in five of 51 patients (9.8%).

Conclusions: Complete ablation of BE can be achieved in a high percentage of patients even in a multicenter design using high-power APC. However, APC has a relevant morbidity. Therefore, ablation of nonneoplastic BE cannot be recommended generally because incidence of cancer in BE is low.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Ulcer Agents / therapeutic use*
  • Argon / therapeutic use
  • Barrett Esophagus / drug therapy*
  • Barrett Esophagus / surgery*
  • Combined Modality Therapy
  • Esomeprazole / therapeutic use*
  • Esophagoscopy
  • Female
  • Humans
  • Laser Coagulation / methods*
  • Logistic Models
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prospective Studies
  • Treatment Outcome


  • Anti-Ulcer Agents
  • Argon
  • Esomeprazole