Role of Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection in the Management of Barrett’s Related Neoplasia - 16/11/20

Doi : 10.1016/j.giec.2020.09.001

Esther A. Nieuwenhuis, MD ^a, Oliver Pech, MD, PhD ^b, Jacques J.G.H.M. Bergman, MD, PhD ^a, Roos E. Pouw, MD, PhD ^a,^⁎
^a Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Location VUmc, De Boelelaan 1118, Amsterdam 1081 HV, the Netherlands
^b Department of Gastroenterology and Hepatology, Krankenhaus Barmherzige Brüder Regensburg, Prüfeninger Str. 86, Regensburg 93049, Germany

^∗Corresponding author.

Résumé

Endoscopic resection has been proven to be safe and highly effective for removing early neoplastic lesions in Barrett esophagus. It enables accurate histopathological assessment and is therefore considered as the cornerstone in the endoscopic work-up for patients with Barrett neoplasia. Various techniques are available to perform endoscopic resection. Multiband mucosectomy is the most commonly used resection technique. However, endoscopic submucosal dissection is gaining ground in the Western world. Endoscopic resection for low-risk submucosal lesions already is fully justified. Future studies have to point out whether endoscopic resection and subsequent follow-up are also justified in selected patients with high-risk submucosal tumors.

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Keywords : Barrett’s esophagus, Barrett’s neoplasia, High-grade dysplasia, Early esophageal adenocarcinoma, Endoscopic resection, Endoscopic mucosal resection, Endoscopic submucosal dissection