Our Esophageal Program offers advanced diagnostic testing and minimally invasive management techniques for many patients with esophageal diseases. These diseases range from motility disorders such as achalasia, distal esophageal spasm, hypercontractile esophagus (nutcracker esophagus/jackhammer esophagus) and gastro-esophageal reflux disease to inflammatory disorders (eosinophilic esophagitis), and esophageal cancers and precancerous conditions.
With respect to motility disorders, we have several experts utilizing state of the art equipment which allows for an improved detection of these conditions. These modalities include high resolution esophageal manometry with impedance and 24 hour pH-impedance testing. We also offer 48 hour BRAVO pH monitoring. Our experts specialize in the treatment of these disorders. Some of the treatments offered include pneumatic dilatation, Botox injection, and Per Oral Esophageal Myotomy (POEM) for Achalasia. POEM, an endoscopic surgical technique which originated in Japan and has become widely practiced throughout Asia, has only recently become available in the US where there are only ~ 20 centers performing this procedure. At the time of this writing* we are the only center in CT performing POEM.
For patients with Barrett’s Esophagus, we have been providing Radiofrequency Ablation (Barrx) with excellent success. This endoscopic procedure is over 90% successful in eradicating Barrett’s, and 5-year data demonstrate no evidence of recurrences following treatment in over 92%. We are one of the busiest and experienced centers in the Northeast and one of the top 35 in the country.
For patient with early esophageal cancer, we are able to provide curative resection via Endoscopic mucosal resection (EMR) for smaller lesions and Endoscopic Submucosal Dissection (ESD) for larger lesions. These are endoscopic techniques that can be curative, thus preventing what would formerly have required surgical removal of a large part of the esophagus. ESD, developed in Japan and largely practiced in Asia, is available in only 20-25 centers in the United States. We are the only center performing ESD in the State of CT and have had excellent results. Following successful endoscopic resection patients in whom cancer arose in the setting of Barrett’s are enrolled in our Radiofrequency Ablation Program to eliminate the risk of future esophageal cancers. We have also used EMR and ESD to provide curative resection for early stomach and colon cancers as well as for patients with tumors residing under the surface of the stomach lining.
We also work closely with the Thoracic Surgeons and Oncologists of Hartford Hospital and associates at The Memorial Sloan Kettering Cancer Center for patients whose cancers are unable to be managed endoscopically.
*December 2014
