The evolution of endoscopic therapy for Barrett’s esophagus

Abstract

Barrett’s esophagus is the condition in which a metaplastic columnar epithelium replaces the stratified squamous epithelium that normally lines the distal esophagus. The condition develops as a consequence of chronic gastroesophageal reflux disease and predisposes the patient to the development of esophageal adenocarcinoma. The diagnosis and management of Barrett’s esophagus have undergone dramatic changes over the years and continue to evolve today. Endoscopic eradication therapy has revolutionized the management of dysplastic Barrett’s esophagus and early esophageal adenocarcinoma by significantly reducing the morbidity and mortality associated with the prior gold standard of therapy, esophagectomy. The purpose of this review is to highlight current principles in the management and endoscopic treatment of this disease.

Clinical adverse events and device failures for the Barrx™ radiofrequency ablation catheter system: a MAUDE database analysis

“…Chest pain, dysphagia, and general post-procedure discomfort were other adverse events commonly reported by patients. Generally, pain and dysphagia occurred 3-4 days post-procedure [ 11 - 13 ]. In our study, chest pain and dysphagia were reported in 17 cases.…”

The Use of Confocal Laser Endomicroscopy in Diagnosing Barrett’s Esophagus and Esophageal Adenocarcinoma

“…BE is the most-known risk factor for the development of EAC, and the risk of EAC is greater by about 30-fold or more among patients with BE compared to that for the general population [ 14 , 15 ]. BE occurs when the normal squamous epithelium of the distal esophagus ( Figure 1 a–c) changes to columnar-lined intestinal-type cells ( Figure 2 a,b), which can usually be seen when the mucosa of the esophagus is repeatedly exposed to gastric acid [ 16 , 17 , 18 ]. Other risk factors for the development of BE are male gender, age, race, smoking, alcohol consumption, and obesity [ 19 , 20 ].…”

Endoscopic Management of Esophageal Cancer

“…Endoscopy has been essential in the detection of lesions suspicious for esophageal cancer and tissue acquisition to make an accurate histologic diagnosis [ 6 ]. As our understanding improves regarding precancerous lesions such as Barrett’s esophagus (BE), a known precursor of EAC, endoscopy has promoted early detection, surveillance, and prevention of progression [ 7 ]. Furthermore, advances in technology have increased the therapeutic applications of endoscopy in curative resection of early cancer and palliation of advanced malignancy.…”