Ortiz-Fernández-Sordo J, Parra-Blanco A, García-Varona A, Rodríguez-Peláez M, Madrigal-Hoyos E, Waxman I, Rodrigo L. Endoscopic resection techniques and ablative therapies for Barrett’s neoplasia. World J Gastrointest Endosc 2011; 3(9): 171-182 [PMID: 21954414 DOI: 10.4253/wjge.v3.i9.171]
Corresponding Author of This Article
Luis Rodrigo, Professor, Department of Gastroenterology, Central University Hospital of Asturias, Celestino Villamil S/N, Oviedo 33006, Asturias, Spain. lrodrigosaez@gmail.com
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Review
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World J Gastrointest Endosc. Sep 16, 2011; 3(9): 171-182 Published online Sep 16, 2011. doi: 10.4253/wjge.v3.i9.171
Endoscopic resection techniques and ablative therapies for Barrett’s neoplasia
Jacobo Ortiz-Fernández-Sordo, Adolfo Parra-Blanco, Alejandro García-Varona, María Rodríguez-Peláez, Erika Madrigal-Hoyos, Irving Waxman, Luis Rodrigo
Jacobo Ortiz-Fernández-Sordo, Adolfo Parra-Blanco, Endoscopy Unit, Department of Gastroenterology, Central University Hospital of Asturias, Celestino Villamil S/N, Oviedo 33006, Asturias, Spain
Jacobo Ortiz-Fernández-Sordo, Erika Madrigal-Hoyos, Irving Waxman, Center for Endoscopic Research and Therapeutics, Department of Medicine, Section of Gastroenterology, University of Chicago Medical Center, 5758 S, Maryland Avenue, Chicago, IL 60637, United States
Alejandro García-Varona, Department of Pathology, Central University Hospital of Asturias, Celestino Villamil S/N, Oviedo 33006, Asturias, Spain
María Rodríguez-Peláez, Luis Rodrigo, Department of Gastroenterology, Central University Hospital of Asturias, Celestino Villamil S/N, Oviedo 33006, Asturias, Spain
Author contributions: Ortiz-Fernández-Sordo J, Parra-Blanco A, Waxman I and Rodrigo L were involved in substantial contributions to manuscript concept and design; Ortiz-Fernández-Sordo J performed data collection, analysis and interpretation; all authors participated in drafting the article, revising and approval of content for final version.
Supported by The Grant for the Consejería de Salud y Servicios Sanitarios del Principado de Asturias
Correspondence to: Luis Rodrigo, Professor, Department of Gastroenterology, Central University Hospital of Asturias, Celestino Villamil S/N, Oviedo 33006, Asturias, Spain. lrodrigosaez@gmail.com
Telephone: +33-985-108058 Fax: +33-985-108115
Received: December 8, 2010 Revised: July 4, 2011 Accepted: August 15, 2011 Published online: September 16, 2011
Abstract
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.
