Open AccessEndoscopic resection techniques and ablative therapies for Barrett’s neoplasia
Author(s) -
Jacobo Ortiz-Fernández-Sordo,
Adolfo ParraBlanco,
Alejandro García Varona,
María Rodríguez-Peláez,
Erika Madrigal-Hoyos,
Irving Waxman,
Luı́s Rodrigo
Publication year - 2011
Publication title -
world journal of gastrointestinal endoscopy
Language(s) - English
Resource type - Journals
ISSN - 1948-5190
DOI - 10.4253/wjge.v3.i9.171
Subject(s) - medicine , endoscopic mucosal resection , dysplasia , barrett's esophagus , esophagus , adenocarcinoma , ablative case , radiofrequency ablation , chromoendoscopy , esophageal cancer , cancer , endoscopy , radiology , ablation , radiation therapy , colonoscopy , colorectal cancer
Esophageal adenocarcinoma is the most rapidly increasing cancer in western countries. High-grade dysplasia (HGD) arising from Barrett's esophagus (BE) is the most important risk factor for its development, and when it is present the reported incidence is up to 10% per patient-year. Adenocarcinoma in the setting of BE develops through a well known histological sequence, from non-dysplastic Barrett's to low grade dysplasia and then HGD and cancer. Endoscopic surveillance programs have been established to detect the presence of neoplasia at a potentially curative stage. Newly developed endoscopic treatments have dramatically changed the therapeutic approach of BE. When neoplasia is confined to the mucosal layer the risk for developing lymph node metastasis is negligible and can be successfully eradicated by an endoscopic approach, offering a curative intention treatment with minimal invasiveness. Endoscopic therapies include resection techniques, also known as tissue-acquiring modalities, and ablation therapies or non-tissue acquiring modalities. The aim of endoscopic treatment is to eradicate the whole Barrett's segment, since the risk of developing synchronous and metachronous lesions due to the persistence of molecular aberrations in the residual epithelium is well established.