***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Radiofrequency ablation ( RFA ) is safe and effective for eradicating Barrett 's esophagus ( BE ) and BE-associated early neoplasia . Most RFA studies have limited the baseline length of BE ( < 10 cm ) , and therefore little is known about RFA for longer BE . OBJECTIVE To assess the safety and efficacy of RFA with or without prior endoscopic resection ( ER ) for BE ≥ 10 cm containing neoplasia . DESIGN Prospect i ve trial . SETTING Two tertiary-care centers . PATIENTS This study involved consecutive patients with BE ≥ 10 cm with early neoplasia . INTERVENTION Focal ER for visible abnormalities , followed by a maximum of 2 circumferential and 3 focal RFA procedures every 2 to 3 months until complete remission . MAIN OUTCOME MEASUREMENTS Complete remission , defined as endoscopic resolution of BE and no intestinal metaplasia ( CR-IM ) or neoplasia ( CR-neoplasia ) in biopsy specimens . RESULTS Of the 26 patients included , 18 underwent ER for visible abnormalities before RFA . The ER specimens showed early cancer in 11 , high- grade intraepithelial neoplasia ( HGIN ) in 6 , and low- grade intraepithelial neoplasia ( LGIN ) in 1 . The worst residual histology , before RFA and after any ER , was HGIN in 16 patients and LGIN in 10 patients . CR-neoplasia and CR-IM were achieved in 83 % ( 95 % confidence interval [ CI ] , 63%-95 % ) and 79 % ( 95 % CI , 58%-93 % ) , respectively . None of the patients had fatal or severe complications and 15 % ( 95 % CI , 4%-35 % ) had moderate complications . During a mean ( ± st and ard deviation ) follow-up of 29 ( ± 9.1 ) months , no neoplasia recurred . LIMITATIONS Tertiary-care center , short follow-up . CONCLUSION ER for visible abnormalities , followed by RFA of residual BE is a safe and effective treatment for BE ≥ 10 cm containing neoplasia , with a low chance of recurrence of neoplasia or BE during follow-up STUDY AIMS The aim of the current study was to evaluate the efficacy and safety of stepwise circumferential and focal ablation using the HALO system for Barrett 's esophagus containing flat , high- grade dysplasia ( HGD ) or residual dysplasia after endoscopic resection for HGD or intramucosal cancer ( IMC ) . METHODS Visible abnormalities were removed with endoscopic resection prior to ablation . Persistence of dysplasia and absence of IMC were confirmed with biopsy after endoscopic resection . A balloon-based electrode was used for primary circumferential ablation and an endoscope-mounted electrode was used for secondary focal ablation . RESULTS Twelve patients ( nine men ; median age 70 years ) were treated ( median Barrett 's length 7 cm ) . Visible abnormalities were removed by endoscopic resection in seven patients . The worst pathological grade of residual Barrett 's esophagus after resection and prior to ablation was low- grade dysplasia ( LGD ) ( n = 1 ) and HGD ( n = 11 ) . Patients underwent a median of one circumferential and two focal ablation sessions . Complete remission of dysplasia was achieved in 12/12 patients ( 100 % ) . Complete endoscopic and histological removal of Barrett 's esophagus was achieved in 12/12 patients ( 100 % ) . There were no ablation-related stenoses , and no subsquamous Barrett 's esophagus was observed in 363 biopsies obtained from post-ablation neo-squamous mucosa . Protocol ized cleaning of the ablation zone and electrode in between ablations result ed in superior regression of Barrett 's esophagus compared with previous studies . During a median follow-up of 14 months no recurrence of dysplasia or Barrett 's esophagus was observed . CONCLUSIONS Stepwise circumferential and focal ablation for Barrett 's esophagus with flat HGD or for Barrett 's with residual dysplasia after endoscopic resection for HGD/IMC is a safe and effective treatment modality . Its success rate and safety profile compare favorably with alternatives such as esophagectomy , widespread endoscopic resection or photodynamic therapy BACKGROUND Barrett 's esophagus ( BE ) may lead to high- grade dysplasia ( HGD ) and adenocarcinoma . The objective was to examine the impact of treating patients with BE and with HGD by using porfimer sodium ( POR ) and photodynamic therapy ( PDT ) for ablating HGD and reducing the incidence of esophageal adenocarcinoma . METHODS The design was a multicenter , partially blinded ( pathology ) , r and omized clinical trial conducted in patients with BE who have HGD . There were 30 contributing centers . A total of 485 patients were screened , with 208 in the intent-to-treat population and 202 in the safety population . Patients were r and omized on a 2:1 basis to compare PDT with POR plus omeprazole ( PORPDT ) with omeprazole only ( OM ) . The main outcome measurement was complete HGD ablation occurring at any time during the study period . RESULTS There was a significant difference ( p < 0.0001 ) in favor of PORPDT ( 106/138 [ 77 % ] ) compared with OM ( 27/70 [ 39 % ] ) in complete ablation of HGD at any time during the study period . The occurrence of adenocarcinoma in the PORPDT group ( 13 % ) ( n=18 ) was significantly lower ( p < 0.006 ) compared with the OM group ( 28 % ) [ corrected ] ( n=20 ) . The safety profile showed 94 % of patients in the PORPDT group and 13 % of patients in the OM group had treatment-related adverse effects . The limitations of the study were that PDT therapy may have had to be applied more than once and that patients spent more time in treatment . The patients and the physicians were not blinded to the treatment . CONCLUSIONS PORPDT in conjunction with omeprazole is an effective therapy for ablating HGD in patients with BE and in reducing the incidence of esophageal adenocarcinoma BACKGROUND Ablation of Barrett 's esophagus ( BE ) has been advocated as a method to eliminate the risk of malignant transformation of BE . OBJECTIVE To provide longer follow-up and determine safety and efficacy of multipolar ablation for nondysplastic BE . DESIGN Prospect i ve cohort study . SETTING Gastroenterology Unit at the Policlinica Metropolitana , a tertiary care center in Caracas , Venezuela . PATIENTS One hundred sixty-six patients with nondysplastic BE and histologic evidence of intestinal metaplasia . INTERVENTIONS Patients underwent multipolar electrocoagulation ablation therapy to areas of BE identified with magnification chromoendoscopy . The identified areas were treated with a 50-W energy source and a 7F " gold " probe . After complete ablation , patients were followed on an annual basis with magnification chromoendoscopy . At annual visits , biopsy specimens were taken in areas identified at baseline as BE . Targeted biopsy specimens were taken in areas of recurrent BE identified by using magnification chromoendoscopy . MAIN OUTCOME MEASUREMENTS Mortality , incidence of recurrent BE , incidence of adenocarcinoma in ablated BE , and morbidity associated with multipolar electrocoagulation .  RESULTS One hundred sixty-six patients were recruited for the study ; 139 completed at least 10 years of follow-up . Complications developed in less than 5 % of patients , all of which were minor . Recurrent BE occurred in less than 5 % of patients . No adenocarcinoma or high- grade dysplasia of the esophagus developed in any of the patients . LIMITATION Uncontrolled clinical trial . CONCLUSIONS Long-term follow-up of ablation of BE with multipolar electrocoagulation ablation therapy indicates that this is a safe , effective method to ablate BE over the long term BACKGROUND Barrett 's esophagus is a premalignant condition induced by gastroesophageal reflux . The aim of this prospect i ve study was to assess the efficacy of argon plasma coagulation in combination with high-dose omeprazole therapy to ablate nondysplastic Barrett 's epithelium . METHODS In 73 patients with histologically confirmed Barrett 's epithelium , argon plasma coagulation was used in combination with maximal acid suppression ( omeprazole 40 mg three times a day ) .  Histologic and endoscopic changes were evaluated at 6- and 12-month intervals . RESULTS In 69 of 70 patients ( 98.6 % ) complete squamous regeneration was achieved after a median of 2 argon plasma coagulation sessions ( range 1 to 5 ) . During a median follow-up of 12 months ( range 2 to 51 months ) there has been no relapse or evidence of the development of dysplasia under continuous acid suppression . Three patients ( 4.3 % ) developed a mild stricture of the distal esophagus that resolved after a single session of bougie dilation . CONCLUSIONS In our experience , argon plasma coagulation in combination with high-dose omeprazole treatment is an effective and safe technique for complete ablation of nondysplastic Barrett 's epithelium . Restoration of squamous mucosa after argon plasma coagulation appears to be long-lasting AIM To report the long-term outcome of patients after complete ablation of non-neoplastic Barrett 's esophagus ( BE ) with respect to BE relapse and development of intraepithelial neoplasia or esophageal adenocarcinoma . METHODS In 70 patients with histologically proven non-neoplastic BE , complete BE ablation was achieved by argon plasma coagulation ( APC ) and high-dose proton pump inhibitor therapy ( 120 mg omeprazole daily ) . Sixty-six patients ( 94.4 % ) underwent further surveillance endoscopy .  At each surveillance endoscopy four-quadrant biopsies were taken from the neo-squamous epithelium at 2 cm intervals depending on the pre-treatment length of BE mucosa beginning at the neo-Z-line , and from any endoscopically suspicious lesion . RESULTS The median follow-up of 66 patients was 51 mo ( range 9 - 85 mo ) giving a total of 280.5 patient years . A mean of 6 biopsies were taken during surveillance endoscopies . In 13 patients ( 19.7 % ) tongues or isl and s suspicious for BE were found during endoscopy . In 8 of these patients ( 12.1 % ) non-neoplastic BE relapse was confirmed histologically giving a histological relapse rate of 3 % per year . In none of the patients , intraepithelial neoplasia nor an esophageal adenocarcinoma was detected . Logistic regression analysis identified endoscopic detection of isl and s or tongues as the only positive predictor of BE relapse ( P = 0.0004 ) . CONCLUSION The long-term relapse rate of non-neoplastic BE following complete ablation with high-power APC is low ( 3 % per year ) i ( n d m e This is one of a series of statements discussing the use of GI endoscopy in common clinical situations . The St and ards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text . In preparing this guideline , a search of the medical literature was performed using PubMed . Additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants . When limited or no data exist from well- design ed prospect i ve trials , emphasis is given to results of large series and reports from recognized experts . Guidelines for appropriate use of endoscopy are based on a critical review of the available data and expert consensus at the time the guidelines are drafted . Further controlled clinical studies may be needed to clarify aspects of this guideline . This guideline may be revised as necessary to account for changes in technology , new data , or other aspects of clinical practice . The recommendations were based on review ed studies and were grade d on the strength of the supporting evidence ( Table 1).1 The strength of individual recommendations is based on both the aggregate evidence quality and an assessment of the anticipated benefits and harms . Weaker recommendations are indicated by phrases such as “ we suggest , ” whereas stronger recommendations are typically stated as “ we recommend . ” This guideline is intended to be an educational device to provide information that may assist endoscopists in providing care to patients . This guideline is not a rule and should not be construed as establishing a legal st and ard of care or as encouraging , advocating , requiring , or discouraging any particular treatment . Clinical decisions in any particular case involve a complex analysis of the patient ’s condition and available courses of action . Therefore , clinical considerations may lead an endoscopist to take a course of action that varies from these guidelines AIM This prospect i ve study evaluated the effectiveness of 90 W argon plasma coagulation ( APC ) for the ablation of Barrett 's esophagus ( BE ) that is considered to be the main risk factor for the development of esophageal adenocarcinoma . METHODS The results from 25 patients , observed 
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The incidence of recurrence after achieving CRIM through endoscopic therapy was substantial .
A small minority of recurrences were dysplastic BE and HGD/EAC .