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Ablation Techniques for Barrett’s Esophagus and Dysplasia

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Adenocarcinoma of the Esophagogastric Junction

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Abstract

The availability of safe and effective endoscopic techniques has caused a major shift in the management of Barrett’s associated dysplasia and early cancer from primarily surgical to endoscopic therapy. Prior to contemplating endoscopic therapy, careful selection of patients is essential and best served by evaluation with multidisciplinary team at specialized centers. This requires detailed examination of Barrett’s segment with removal of nodules or suspicious areas with endoscopic mucosal resection and expert confirmation of dysplasia by at least two gastrointestinal pathologists. This should be followed by eradication of remaining Barrett’s segment with ablation and ongoing vigilant surveillance as recurrences have been reported. Endoscopic therapy is considered in Barrett’s associated intramucosal cancer, Barrett’s esophagus with high-grade dysplasia, confirmed cases of low-grade dysplasia, and rare instances of non-dysplastic Barrett’s such as those with long segment and family history as complete eradication of Barrett’s esophagus is associated with marked reduction in cancer risk. Palliative therapy with photodynamic therapy or cryotherapy can be considered in selected cases of inoperable cancer.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology/A30, Cleveland Clinic, Center of Excellence for Barrett’s Esophagus, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Prashanthi N. Thota

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  1. Prashanthi N. Thota
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Correspondence to Prashanthi N. Thota .

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Editors and Affiliations

  1. Upper Gastrointestinal and General Surgery, University of Verona, Verona, Italy

    Simone Giacopuzzi

  2. Upper Gastrointestinal and General Surgery, University of Verona, Verona, Italy

    Andrea Zanoni

  3. Upper Gastrointestinal and General Surgery, University of Verona, Verona, Italy

    Giovanni de Manzoni

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Thota, P.N. (2017). Ablation Techniques for Barrett’s Esophagus and Dysplasia. In: Giacopuzzi, S., Zanoni, A., de Manzoni, G. (eds) Adenocarcinoma of the Esophagogastric Junction. Springer, Cham. https://doi.org/10.1007/978-3-319-28776-8_4

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  • DOI: https://doi.org/10.1007/978-3-319-28776-8_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28774-4

  • Online ISBN: 978-3-319-28776-8

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