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Learning curves and the influence of procedural volume for the treatment of dysplastic Barrett’s esophagus by Gideon Lipman; Sheraz Markar; Abhinav Gupta; Rehan J. Haidry; Laurence B. Lovat; Marco Novelli; Matthew Banks; Vinay Sehgal; David Graham; Rami Sweis; Danielle Morris; Haroon Miah; Jason M. Dunn; Howard L. Smart; Pradeep Bhandari; Lesley Smith; Robert Willert; Grant Fullarton; John Morris; Massimiliano Di Pietro; Charles Gordon; Ian Penman; Hugh Barr; Praful Patel; Philip Boger; Neil Kapoor; Jonathan Hoare; Natalie Direkze; Yeng Ang; Andrew Veitch; Krish Ragunath; Edward Cheong; Anjan Dhar; David Nylander; Brinder Mahon; Ravi Narayanasamy; Dermot O’Toole is a Medicine article available to read on EtoBox.

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## Background and aims: Endoscopic resections and radiofrequency ablation (rfa) are the established treatments for barrett's-associated dysplasia and early esophageal neoplasia. the uk rfa registry collects patient outcomes from 24 centers treating patients in the united kingdom and ireland. learning curves for treatment of barrett's dysplasia and the impact of center caseload on patient outcomes is still unknown. ## Methods: We examined outcomes of 678 patients treated with rfa in the uk registry using risk-adjusted cumulative sum control chart (ra-cusum) analysis to identify change points in complete resolution of intestinal metaplasia (cr-im) and complete resolution of dysplasia (cr-d) outcomes. we compared outcomes between those treated at high-volume (>100 enrolled patients), medium-volume (51-100), and low-volume (<50) centers. ## Results: There was no association between center volume and cr-im and cr-d rates, but recurrence rates were lower in high-volume versus low-volume centers (log rank p = .001). there was a significant change point for outcomes at 12 cases for cr-d (reduction from 24.5% to 10.4%; p < .001) and at 18 cases for cr-im (30.7% to 18.6%; p < .001) from ra-c

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Author

Gideon Lipman; Sheraz Markar; Abhinav Gupta; Rehan J. Haidry; Laurence B. Lovat; Marco Novelli; Matthew Banks; Vinay Sehgal; David Graham; Rami Sweis; Danielle Morris; Haroon Miah; Jason M. Dunn; Howard L. Smart; Pradeep Bhandari; Lesley Smith; Robert Willert; Grant Fullarton; John Morris; Massimiliano Di Pietro; Charles Gordon; Ian Penman; Hugh Barr; Praful Patel; Philip Boger; Neil Kapoor; Jonathan Hoare; Natalie Direkze; Yeng Ang; Andrew Veitch; Krish Ragunath; Edward Cheong; Anjan Dhar; David Nylander; Brinder Mahon; Ravi Narayanasamy; Dermot O’Toole

Publisher

Elsevier Science; Elsevier ; Mosby Inc.; Elsevier BV (ISSN 1097-6779)

Published

2020

Language

EN

Field

Medicine (Health Sciences)