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New endoscopic and surgical treatment options for early esophageal adenocarcinoma
Author(s) -
Gan Susan,
Watson David I
Publication year - 2010
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2010.06421.x
Subject(s) - medicine , esophagectomy , esophageal cancer , endoscopic mucosal resection , esophagus , stage (stratigraphy) , endoscopy , surgery , endoscopic treatment , barrett's esophagus , esophageal disease , esophageal adenocarcinoma , general surgery , adenocarcinoma , cancer , biology , paleontology
Although the outcome for advanced stage esophageal cancer is poor, the early detection and treatment of early stage disease is usually associated with a much better outcome. Until recently, esophagectomy has been the treatment of choice in fit patients. However, morbidity is significant, and this has encouraged the development of newer endoscopic treatments that preserve the esophagus. These techniques include ablation and mucosal resection. Promising results are described, and endoscopic methods might provide a reasonable alternative for the treatment of early esophageal cancer. However, follow‐up remains short and endoscopic treatment does not deal with potential lymphatic spread. Hence, careful selection is required. Minimally invasive techniques for esophageal resection have also been shown to be feasible, although there is only limited evidence that they reduce postoperative morbidity. Better data are still required to demonstrate improved outcomes from endoscopic treatment and minimally invasive esophagectomy.