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Abstract
Introduction: Barrett’s esophagus (BE) is a premalignant condition that requires surveillance, in order to diagnose and treat dysplasia, improving survival. Results from surveillance and endoscopic treatment are well-described in different populations. This is the first evaluation of the outcomes of endoscopic resection and ablation of BE patients in a Portuguese center. Methods: This is a single-center retrospective cohort study analyzing the results of endoscopic surveillance and treatment of patients with BE between January 2004 and September 2024. The following outcomes were evaluated: detection of dysplasia and/or visible lesions; rate of curative endoscopic resection; rate of BE refractory to ablation; adverse event (AE) rates of endoscopic resection and ablation; BE-related mortality and survival. Results: Eighty-nine patients were followed for a median of 3 years (interquartile range 1–6). A total of 37 lesions were identified, and treated with endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD) and other modalities in 76%, 16%, and 8% of patients, respectively, with curative resection and AE rates of 86% (95% CI: 67%–96%) and 11% (95% CI: 2%–28%) for EMR, and 67% (95% CI: 22%–96%) and 17% (95% CI: 0%–64%) for ESD, respectively. A response rate of 97% was observed in 33 patients submitted to mucosal ablation, with 1 patient presenting refractory disease and 1 patient showing recurrence of intestinal metaplasia. One patient died of BE-related neoplasia. Conclusion: Our study shows results of BE treatment generally comparable to published literature, in a low-prevalence country. A high curative resection and a high success rate of mucosal ablation were achieved, with low refractory and recurrent disease.
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