Endoscopic therapy for Barrett's esophagus and early esophageal cancer:Where do we go from here?

查看全文 作　　者：Tavankit [1]Singh;Madhusudhan R [1]Sanaka;Prashanthi N [1]Thota

机构地区：[1]Department of Gastroenterology and Hepatology,Cleveland Clinic

出　　处：《World Journal of Gastrointestinal Endoscopy》索引2018年第10卷第9期,共10页

摘　　要：Since Barrett's esophagus is a precancerous condition,efforts have been made for its eradication by various ablative techniques.Initially,laser ablation was attempted in non-dysplastic Barrett's esophagus and subsequently,endoscopic ablation using photodynamic therapy was used in Barrett's patients with high-grade dysplasia who were poor surgical candidates.Since then,various ablative therapies have been developed with radiofrequency ablation having the best quality of evidence.Resection of dysplastic areas only without complete removal of entire Barrett's segment is associated with high risk of developing metachronous neoplasia.Hence,the current standard of management for Barrett's esophagus includes endoscopic mucosal resection of visible abnormalities followed by ablation to eradicate remaining Barrett's epithelium.Although endoscopic therapy cannot address regional lymph node metastases,such nodal involvement is present in only 1% to 2% of patients with intramucosal adenocarcinoma in Barrett esophagus and therefore is useful in intramucosal cancers.Post ablation surveillance is recommended as recurrence of intestinal metaplasia and dysplasia have been reported.This review includes a discussion of the technique,efficacy and complication rate of currently available ablation techniques such as radiofrequency ablation,cryotherapy,argon plasma coagulation and photodynamic therapy as well as endoscopic mucosal resection.A brief discussion of the emerging technique,endoscopic submucosal dissection is also included. 关键词：ENDOSCOPIC MUCOSAL resection Barrett’s ESOPHAGUS DYSPLASIA ADENOCARCINOMA ENDOSCOPIC therapy Radiofrequency ablation

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Endoscopic therapy for Barrett's esophagus and early esophageal cancer:Where do we go from here?

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