title: Laparoscopic transgastric esophageal mucosal resection: a treatment option for patients with high-grade dysplasia in Barrett's esophagus.
abstract: BACKGROUND
  We present long-term follow-up data on patients with esophageal high-grade dysplasia and/or carcinoma in situ who were treated with laparoscopic transgastric esophageal mucosal resection (LTEMR).
  
  
  METHODS
  Patient demographics, operative outcomes, and follow-up results were tabulated.
  
  
  RESULTS
  LTEMR was performed in 11 patients (9 male, 2 female). The median age was 54 (44 to 75) years. The 30-day morbidity or mortality was zero. The median follow-up was 5.2 (2 to 12) years. Upper endoscopy was performed at 3, 6, and 12 month, and yearly thereafter. All patients regenerated squamous epithelium at 6 months. One patient developed a recurrence of Barrett's epithelium 2 years after resection. No recurrences of high-grade dysplasia or carcinoma were observed in any of the patients. Two patients developed an esophageal stricture; both were treated successfully with endoscopic balloon dilation and have suffered no further sequelae.
  
  
  CONCLUSIONS
  LTEMR is safe and effective alternative method to treat patients with Barrett's esophagus with high-grade dysplasia.
authors.affiliation: Chicago Institute of Minimally Invasive Surgery, 4905 Old Orchard Center, Suite 409, Skokie, IL 60077, USA. Electronic address: shaun_daly@rush.edu.
authors.forename: Constantine T
authors.initials: CT
authors.lastname: Frantzides
authors.affiliation: Department of Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Shaun C
authors.initials: SC
authors.lastname: Daly
authors.affiliation: Chicago Institute of Minimally Invasive Surgery, 4905 Old Orchard Center, Suite 409, Skokie, IL 60077, USA.
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Frantzides
authors.affiliation: Chicago Institute of Minimally Invasive Surgery, 4905 Old Orchard Center, Suite 409, Skokie, IL 60077, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Manelis
authors.affiliation: Chicago Institute of Minimally Invasive Surgery, 4905 Old Orchard Center, Suite 409, Skokie, IL 60077, USA.
authors.forename: Algis
authors.initials: A
authors.lastname: Marcinkevicius
authors.affiliation: Department of Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Minh B
authors.initials: MB
authors.lastname: Luu
mesh_terms: D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Barrett's esophagus; Endoscopic resection; High-grade dysplasia; Mucosal resection