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The role of esophagectomy in the management of Barrett's esophagus with high‐grade dysplasia
Author(s) -
Badgery Henry,
Read Matthew,
Winter Nicole N.,
Taylor Andrew C. F.,
Hii Michael W.
Publication year - 2020
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/nyas.14439
Subject(s) - esophagectomy , medicine , dysplasia , esophagus , barrett's esophagus , concomitant , esophageal disease , endoscopy , disease , general surgery , surgery , gastroenterology , esophageal cancer , adenocarcinoma , cancer
Barrett's esophagus (BE) with high‐grade dysplasia (HGD) has previously been a routine indication for esophagectomy. Recent advances in endoscopic therapy have resulted in a shift away from surgery. Current international guidelines recommend endoscopic therapy for BE with HGD irrespective of recurrence or progression of dysplasia. Current guidelines do not address the ongoing role of esophagectomy as an adjunct in the setting of failed endoscopic therapy. This review examines the role of esophagectomy as an adjunct to endoscopy in the management of patients with BE and HGD, with a specific focus on patients with persistent, progressive, or recurrent disease, disease resistant to endoscopic therapy, in patients with concomitant esophageal pathology, and in those patients in whom lifelong surveillance may not be possible or desired.