Management of high-grade dysplasia in patients with Barrett's esophagus

In the past, the standard management for patients with high-grade dysplasia in Barrett's esophagus was esophagectomy, in part on the basis of the assumption that the patient was likely to harbor an undetected carcinoma. With better awareness of the safety of surveillance protocols, improved prospective surveillance, and experience with cohorts of patients in whom incident early lesions unassociated with invasive carcinomas are detected, endoscopic techniques for treatment of Barrett-associated neoplasia have become excellent alternatives to esophagectomy for appropriately selected patients. Emerging endoscopic techniques offer an opportunity for better evaluation of patients with Barrett's-associated neoplasia.