Total endoscopic resection of Barrett esophagus

Area of Science:

• Gastroenterology
• Endoscopy
• Oncology

Background:

• Barrett's esophagus with high-grade intraepithelial neoplasia has a high annual progression rate (>10%).
• Endoscopic resection is a less invasive option than surgery for managing high-grade intraepithelial neoplasia and intramucosal cancer.
• Current management strategies include localized resection and total endoscopic resection of Barrett's mucosa.

Purpose of the Study:

• To review techniques for total endoscopic resection of Barrett's esophagus.
• To summarize key published data on total endoscopic resection strategies.
• To compare different endoscopic resection methods for Barrett's esophagus.

Main Methods:

• Review of published literature on endoscopic resection techniques for Barrett's esophagus.
• Description of localized resection versus total endoscopic resection.
• Discussion of piecemeal endoscopic mucosal resection and endoscopic submucosal dissection.

Main Results:

• Total endoscopic resection aims to remove all at-risk Barrett's mucosa.
• Piecemeal endoscopic mucosal resection is a common technique for total resection.
• Endoscopic submucosal dissection is being explored for en bloc resection.

Conclusions:

• Total endoscopic resection is a viable strategy for managing high-grade intraepithelial neoplasia in Barrett's esophagus.
• Endoscopic resection techniques, including ESD, are evolving for improved outcomes.
• Further data summarization is needed to guide clinical practice.