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World Journal of Surgery

Erschienen in:

01.03.2015

Endoscopic Treatments for Dysplastic Barrett’s Esophagus: Resection, Ablation, What Else?

verfasst von: Charumathi Raghu Subramanian, George Triadafilopoulos

Erschienen in: World Journal of Surgery | Ausgabe 3/2015

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Abstract

Background

Endoscopic eradication therapy for dysplastic Barrett’s esophagus (BE) comprises resection and mucosal ablation techniques. Over the years, these techniques have been tried with success, not only for dysplastic Barrett’s epithelium but also for non-dysplastic Barrett’s epithelium and early adenocarcinoma. Endoscopic resection is usually carried out for visible lesions, either as endoscopic mucosal resection (EMR), which is practiced widely in Western countries, or as endoscopic submucosal dissection, which is more popular in Japan and throughout Asia. Among ablative techniques are photodynamic therapy, cryotherapy, and radiofrequency ablation (RFA).

Methods

We reviewed the published evidence pertaining to endoscopic treatments of dysplastic BE, with emphasis on the various resection and ablative techniques, their safety, efficacy, durability of effect, and tolerability.

Results

Both resection and ablation procedures performed endoscopically have been proved effective, and safe for treating dysplastic BE and early adenocarcinoma. Among the ablative techniques, RFA has shown to be more effective and safe, and is preferred for most cases.

Conclusions

Endoscopic therapies have revolutionized the treatment of BE and have minimized the need for surgical intervention in many patients. Concomitant treatment of acid reflux with proton pump inhibitors and continuous surveillance are essential. Combination techniques such as EMR followed by RFA may be also considered in some cases.

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Titel: Endoscopic Treatments for Dysplastic Barrett’s Esophagus: Resection, Ablation, What Else?
verfasst von: Charumathi Raghu Subramanian
George Triadafilopoulos
Publikationsdatum: 01.03.2015
Verlag: Springer US
Erschienen in: World Journal of Surgery / Ausgabe 3/2015
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-014-2636-6

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Abstract

Background

Methods

Results

Conclusions

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