Revisiting Barrett's Esophagus

Part I Morphologic backgrounds

1 Macroscopic anatomy of esophagus
Stefania Montagnani, Clotilde Castaldo

2 Microscopic anatomy and histology of esophagus
Stefania Montagnani, Franca Di Meglio

Part II Epidemiology and natural history

3 Definition and epidemiology of Barrett's esophagus
Alessandra Romiti, Rocco Maurizio Zagari

4 Pathophysiolgy of esophageal reflux disease and natural history of Barrett's esophagus
Paola Iovino, Antonella Santonicola, Nigel J Trudgill

• Gastro-esophageal reflux disease
• Natural history of Barrett's esophagus
• Natural history of non dysplastic Barrett's esophagus
• Natural history of Barrett's esophagus indefinite for dysplasia
• Natural history of Barrett's esophagus with low grade dysplasia
• Natural history of Barrett's esophagus with high grade dysplasia

5 Obesity: Barrett's esophagus and esophageal cancer risk
Jan Marc Chevallier, Sonja Chiappetta, Mario Musella

• Introduction
• Factors leading to GERD
• Obesity, Barrett's ulcer, and risk of cancer
• Bariatric surgery and risk of GERD
• GERD following restrictive procedures
• GERD following gastric by-pass procedures

Part III Diagnosis

6 First level endoscopy in Barrett's esophagus: endoscopic pictures, Prague classification and biopsy protocols
Massimo Conio, Antonella De Ceglie, Mattia Crespi

• Endoscopic pictures
• Prague classification
• Biopsy protocol

7 Augmented endoscopy in Barrett's esophagus: zoom endoscopy, traditional, and virtual chromoendoscopy
Giuseppe Galloro, Raffaele Manta, Nico Pagano, Teresa Russo, Donato Alessandro Telesca, Andrea Parodi, Cesare Formisano

• Introduction
• Traditional chromoendoscopy
• High definition, zoom, and magnifying endoscopy
• Computed virtual chromoendoscopy

8 Confocal LASER endomicroscopy in Barrett's esophagus: is it a clinical resource or still a research procedure?
Giovanni Domenico De Palma, Gianluca Cassese, Gaetano Luglio

• Confocal LASER endomicroscopy: theoretical and practical bases
• Technical notes
• CLE for Barrett's esophagus management
• Current limitations and possibilities for future development
• Conclusions

9 Histology: the different points of view on Barrett's esophagus
Vincenzo Villanacci, Karel Geboes, Tiziana Salviato, Gabrio Bassotti

• Normal esophagus
• Endoscopic and microscopic diagnosis of Barrett's esophagus
• Is all intestinal metaplasia equivalent to Barrett's esophagus?
• Dysplasia in Barrett's esophagus

10 The role of molecular biology in diagnosis and follow-up of Barrett's esophagus
Karen Geboes, Anne Hoorens

• Introduction
• Molecular pathways implicated in development of Barrett's esophagus
• Molecular markers for the diagnosis
• Markers for the diagnosis of dysplasia
• Genome-wide association studies for the development of Barrett's esophagus
• Molecular pathways implicated in the transition of Barrett's esophagus to early adenocarcinoma
• Molecular biology of progression to adenocarcinoma
• Molecular markers for the diagnosis of progression to EAC.
• Genetic changes involved in the progression from BE to EAC.
• Biomarker development
• Conclusions

11 Timing and protocols of clinical and endoscopic surveillance of Barrett's esophagus
Carlo Calabrese, Marco Salice, Nico Pagano, Raffaele Manta, Fernando Rizzello

• Protocol

Part IV Treatments

12 Lifestyles, medical therapy, and chemoprevention
Giancarlo Sarnelli, Alessandra D'Alessandro, Raf Bisschops

• Physical activity and diet
• Smoking and alcohol intake
• Chemoprevention

13 Photodynamic therapy
Raffaele Manta, Dolores Sgambato, Nico Pagano, Giuseppe Galloro

• Introduction
• Technique
• Data of literature
• Limits
• Controindications
• State of the art

14 Cryotherapy
Nico Pagano, Raffaele Manta, Giuseppe Galloro

• Introduction
• Physical principles and technical consideration
• Clinical results
• Conclusions

15 Endoscopic resections: EMR and ESD
Filippo Catalano, Seichiro Abe, Yutaka Saito

16 Radiofrequency ablation
Jason Samarasena, David Lee, Kenneth J Chang

• Introduction
• Indications
• Equipment
• Technique
• Post procedure
• Efficacy
• Adverse events
• Cost-effectiveness analysis
• Buried Barrett's Esophagus
• Conclusions

17 What we have to do after the treatment of metaplasia or dysplasia in Barrett's esophagus? Protocols and timing of follow-up in the treated patient
Jose Miguel Esteban

• Introduction
• Endoscopic therapies of Barrett's esophagus
• Surveillance after endoscopic therapy
• Surveillance Strategies
• Publications regarding Protocols and Timing for surveillance
• Protocols and timing of follow-up in the treated patient recommendations
• Special considerations
• Conclusions

18 Is there a role for the surgeon in therapeutic management of Barrett esophagus?
Uberto Fumagalli Romario, Paul Magnus Schneider

• Introduction
• Does BE regress after ARS and/or does ARS reduce the cancer risk in BE?
• Which type of surgery for short and long segment Barrett's esophagus ?
• Role of ARS to prevent BE remission following endoscopic ablation procedures
• Role of ARS to prevent BE recurrence or progression after endoscopic ablation procedures

19 Early adenocarcinoma in Barrett esophagus: is this an endoscopic or a surgical problem?
Antonello Trecca, Takuji Gotoda

This book focuses on Barrett's Esophagus (BE), a clinical condition that must be evaluated in all patients affected by chronic GERD, and with an important link to esophageal cancer. Divided into four sections (morphological background, epidemiology and natural history, diagnosis, and treatments), this handy volume provides the latest indications regarding endoscopic approaches (first level and advanced endoscopy), pathological studies (pathology and molecular biology), and state-of-the-art therapeutic options (medical, endoscopic, and surgical) for BE. As such, it offers a valuable reference guide for all professionals involved in the management of BE (gastroenterologists, endoscopists, pathologists and surgeons), offering them a comprehensive overview and deeper understanding of this seemingly superficial disease.

After completing his medical school degree, Professor Giuseppe Galloro earned his post-graduate specialization in General Surgery, both with honors. Following his post-graduate training as a junior doctor at the General Surgery Department of the University of Naples Federico II - School of Medicine, he was appointed as assistant and then resident fellow at the same department. He later became a consultant at the Digestive Surgical Endoscopy Unit and Researcher in General Surgery. He was nominated as an Assistant Professor (2004) and Associated Professor (2015) of General Surgery at the University of Naples Federico II - School of Medicine, as well as head of the Diagnostic and Therapeutic Endoscopy of Non Neoplastic Diseases of the Digestive System, Biliary Tract and Pancreas Section at the same hospital. He currently teaches several graduate and post-graduate courses (on general surgery, digestive diseases, and digestive endoscopy). His main clinical and research practice is on new techniques and methodologies in diagnostic and operative endoscopy of pre neoplastic diseases and early digestive cancers; endoscopic management of obesity; computing applications and new materials applied to endoscopy. He has authored various volumes of congress proceedings, monographs and journal articles, and has been an invited speaker at over three hundred national and international congresses.