Abstract
Barrett’s oesophagus is a well-recognised precursor of oesophageal adenocarcinoma. The incidence of oesophageal adenocarcinoma is continuing to rise in the Western world with dismal survival rates. In recent years, efforts have been made to diagnose Barrett’s earlier and improve surveillance techniques in order to pick up cancerous changes earlier. Recent advances in endoscopic therapy for early Barrett’s cancers have shifted the paradigm away from oesophagectomy and have yielded excellent results.
Highlights
Barrett’s oesophagus (BO) is defined as the replacement of the normal distal oesophageal squamous epithelium with metaplastic columnar epithelium[1]. This metaplastic epithelium accumulates genetic changes that over time can progress to dysplasia and cancer[2]
Chevaux et al.[69] reported on their outcomes of 75 consecutive patients; endoscopic submucosal dissection (ESD) was performed on lesions of more than 15 mm, achieving an en bloc resection rate of 90% and a neoplasia eradication rate of 92%, and oesophageal strictures developed in 60% of patients
A recently reported randomised controlled trial of endoscopic mucosal resection (EMR) (n = 20) versus ESD (n = 31) demonstrated superior en bloc, R0 and curative resection rates for ESD; there was no difference in clinical outcome for either technique[72]
Summary
Barrett’s oesophagus (BO) is defined as the replacement of the normal distal oesophageal squamous epithelium with metaplastic columnar epithelium[1]. NBI is the most studied optical imaging technology far and has a sensitivity and specificity of 47%–100% and 72%–100%, respectively, for detecting Barrett’s neoplasia[27,31,32,33,34]. A meta-analysis which included data from six trials found that overall methylene blue chromoendoscopy was not superior to random biopsies in the detection of specialised intestinal metaplasia or dysplasia[46].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
