Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection in Barrett's Esophagus

Early detection of neoplastic lesions in Barrett's esophagus is essential for curative treatment. Endoscopic resection (ER) is effective for the treatment of these lesions and enables accurate histologic diagnosis. Most used ER techniques include band-assisted endoscopic mucosal resection (multiband mucosectomy [MBM]) and endoscopic submucosal dissection (ESD). MBM allows for quick removal of lesions less than 20 mm. ESD is a more challenging technique and enables en-bloc resection of larger, deeper invading lesions. Both have similar safety and efficacy outcomes. While we await data of prospective studies, the choice should be individualized based on lesion characteristics, patient factors, and endoscopist expertise.