[Barrett's esophagus: endoscopic treatment of high-grade dysplasia and early cancer].
In a Barrett's oesophagus without dysplasia, endoscopic control every 3-5 years is sufficient. If low-grade dysplasia is encountered in the surveillance biopsies, then endoscopy should be repeated within 3-6 months and yearly thereafter if the low-grade dysplasia persists. Antacid medication must be prescribed in cases with extensive inflammation. The endoscopic treatment of patients with high-grade dysplasia and/or early cancer of the mucosa in a Barrett's oesophagus (tissue ablation and/or mucosa resection) seems a promising alternative to surgery in view of the combination of effectiveness, limited invasiveness compared to surgical resection, and the preservation of a functional oesophagus. Data from long-term follow-up are still limited. Strict endoscopic surveillance will probably detect metachronic abnormalities in an early and still curable stage, creating a new opportunity for endoscopic treatment.
Bergman
J J
JJ
Afd. Maag-, Darm- en Leverziekten, Academisch Medisch Centrum, Meibergdreef 9, 1105 AZ Amsterdam. j.j.bergman@amc.uva.nl
Marsman
W A
WA
Krishnadath
K K
KK
Fockens
P
P
van Lanschot
J J
JJ
Tytgat
G N
GN
D001471:Barrett Esophagus / Q000473:pathology / Q000601:surgery*; D001706:Biopsy; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000473:pathology; D006801:Humans; D009367:Neoplasm Staging; D011230:Precancerous Conditions / Q000473:pathology / Q000601:surgery*