Endoscopic Therapy for Barrett's Esophagus

About this book

Endoscopic Therapy (ET) is emerging as the preferred therapy for early neoplasia in Barrett's Esophagus– i.e. high grade dysplasia (HGD) and early esophageal adenocarcinoma (EAC). Three major benefits of this approach include the fact that endoscopic therapy is associated with rare mortality compared to a 3-5% operative mortality for even high volume surgical centers; the morbidity of endoscopic therapy is time limited compared to the lifelong morbidity after surgical removal of the esophagus, and the maintenance of a functioning esophagus is a major advantage of ET for patient quality of life.

This volume will provide the key decision making factors in determining ET for an individual patient. All current techniques and complications of ET are provided including, photodynamic therapy (PDT), APC, multipolar electrocoagulation (MPEC), RF, ER, and cryotherapy. Each technique includes "how to highlights", high quality color endoscopic images, line drawings and diagrams. The volume also covers defining the threshold target for application, cost-effectiveness of ET and decision making in ablation.

Written for:

Practicing Gastroenterologists

Keywords:

Ablation
Endoscopic therapy
Esophagectomy
High grade dysplasia

Table of contents

1. Defining the threshold target for application: real time dysplasia recognition. Endoscopic detection of dysplasia "optical biopsy" is emerging in clinical practice – Wallace

Techniques of ET and their complications:

Photodynamic Therapy (PDT): the best validated procedure – Lightdale

APC: the most widely applied technique – Attwood

Multipolar Electrocoagulation (MPEC): an early widely available method – Sharma

RF: the most recent application – Bergman

ER: a co-modality for staging and ablation of mucosal irregularities – Wang

Experimental: cryotherapy, etc. – Paricha

Combination: multi-modality therapy – Ell

Decision Making in Ablation:

Disease factors, patient factors, institutional expertise, patient preferences: Falk

Cost-effectiveness of ET: Hur