A novel esophageal-preserving approach to treat high-grade dysplasia and superficial adenocarcinoma in the presence of chronic gastroesophageal reflux disease.
BACKGROUND
The optimal treatment strategy of esophageal high-grade dysplasia (HGD) and superficial adenocarcinoma remains controversial.


METHODS
Here, we describe endoscopic, circumferential mucosal-submucosal en-bloc resection of the entire abnormal esophageal epithelium with extracellular matrix (ECM) placement to regenerate neoepithelium and minimize stricture. That procedure was then followed by a laparoscopic fundoplication as a novel esophageal-preserving approach to treat HGD and superficial adenocarcinoma in the face of chronic gastroesophageal reflux disease (GERD).


CONCLUSIONS
This approach could be an ideal option as an alternative to esophagectomy in selected patients.
Division of Thoracic and Foregut Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Shadyside Medical Center, Suite 715, 5200 Centre Avenue, Pittsburgh, PA 15232, USA. hoppot2@upmc.edu
Toshitaka
T
Hoppo
Stephen F
SF
Badylak
Blair A
BA
Jobe
D000230:Adenocarcinoma / Q000150:complications* / Q000601:surgery; D000368:Aged; D002908:Chronic Disease; D004938:Esophageal Neoplasms / Q000150:complications* / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004947:Esophagus / Q000473:pathology / Q000601:surgery*; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged