RFA uses radiofrequency energy to cause tissue injury and necrosis of the In this review, we will provide aīrief overview of the various EET modalities available and focus on indications, Into resection techniques and ablation techniques. 7 Since then, multiple EET modalities were developed and can be categorized 6 This concept was first confirmed using endoscopic laser treatment more thanĢ0 years ago. There is regeneration of normal esophageal squamous mucosa after ablating BE. The main principle behind EET is that under maximal acid suppression, Mortality, decreased cost and similar survival rates when compared with radicalĮsophagectomy. 6 Over the last 2 decades, however, there has been a shift towards endoscopicĮradication therapies (EETs) considering their lower procedural morbidity and Up until the last 2 decades, esophagectomy was the standard of care for BE with HGDĪnd intramucosal cancer (IMC), with up to 95% 5-year survival rates, but very highĬomplication rates ranging between 30% and 50%. While non-dysplasticīE (NDBE) carries a small annual risk of progressing to EAC (0.3%), 3 the risk increases to 0.5% in the presence of low-grade dysplasia (LGD) 4 and 7% with high-grade dysplasia (HGD). 2 BE is of significance due to its increased risk of progressing to esophagealĪdenocarcinoma (EAC), especially in the presence of dysplasia. 1 It is a result of chronic mucosal injury due to gastroesophageal refluxĭisease (GERD) and is estimated to be present in up to 15% of GERD patients. Stratified squamous epithelial lining of the esophagus, with biopsy-proven The focus of this review article is to present the indications,Ĭontraindications and limitations of EET.īarrett’s esophagus (BE) is defined as an extension of metaplastic columnarĮpithelium of at least 1 cm above the gastroesophageal junction, replacing the Metaplastic tissue underneath the neosquamous epithelium, following ablation. An area of concern is buried metaplasia reported to occur followingĪblation therapy and thought to be from de novo growth of Post-ablation surveillance is mandatory, as recurrences areĬommon. Its limitations and is not 100% effective: it targets a small subset of patientsĪlong the spectrum of BE and esophageal adenocarcinoma, as most patients withĮsophageal adenocarcinoma remain asymptomatic until the disease has progressed Patients usually require multiple ablation sessions with a goal ofĪchieving complete eradication of metaplasia. Techniques usually reserved for nodular/raised lesions or lesions with suspected Into two groups: ablation therapies and resection techniques with resection Multiple EET modalities are available and can be categorized ![]() Low-grade dysplasia, and in highly selected cases of non-dysplastic BE and With high-grade dysplasia and intramucosal cancer, confirmed, and persistent Outpatient setting, has a safe risk profile. Which carries very high mortality and morbidity. ![]() Endoscopic eradication therapy (EET) has revolutionized management of Barrett’sĮsophagus (BE)-associated neoplasia, traditionally treated by esophagectomy,
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