Emedinews:Barrett's esophagus and high-grade dysplasia management

For most patients with Barrett’s esophagus and high-grade dysplasia who are fit to undergo endoscopy one should opt for endoscopic eradication therapy rather than esophagectomy or intensive endoscopic surveillance. Guidelines issued by the American Gastroenterological Association in 2011 now suggest endoscopic eradication therapy as the preferred approach for patients with Barrett’s esophagus and high-grade dysplasia.

To tackle increased risk for esophageal adenocarcinoma, uptill now neoplastic epithelium was removed by esophagectomy but the procedure carried significant procedure-related mortality and long-term morbidity.

The current recommendation is endoscopic eradication therapy, which includes endoscopic mucosal resection followed by radiofrequency ablation.

American Gastroenterological Association. American Gastroenterological Association Medical Position Statement on the Management of Barrett's Esophagus. Gastroenterology 2011; 140:1084.