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Durability of Endoscopic Treatment for Dysplastic Barrett’s Esophagus

  • Craig C. Reed
  • Nicholas J. ShaheenEmail author
Endoscopy (P Siersema, Section Editor)
  • 49 Downloads
Part of the following topical collections:
  1. Topical Collection on Endoscopy

Abstract

Purpose of review

This review discusses the durability of the neo-squamous esophageal epithelium following endoscopic eradication therapy of dysplastic Barrett’s esophagus. Our review will focus primarily on patients treated with radiofrequency ablation; however, we describe the known durability of cryotherapy. Additionally, we discuss the utility of novel imaging technologies and the efficacy of chemopreventive medications following endoscopic ablation.

Recent findings

Mounting data describe the durability of the post-ablation esophagus. Dysplastic Barrett’s esophagus and adenocarcinoma following ablation are rare. New data emphasize that most recurrent disease occurs in the initial year following treatment. Additionally, recent publications suggest that a much-attenuated surveillance interval may provide adequate detection of neoplasia with many fewer surveillance endoscopies.

Summary

Future guidelines will likely liberalize surveillance intervals following endoscopic eradication therapy. Additionally, further longitudinal studies will need to assess the length of time for which surveillance is indicated. The utility of chemopreventive strategies and adjunctive imaging modalities in the maintenance and surveillance of the post-ablation esophagus also remain unclear and will be areas for future investigation.

Keywords

Barrett’s esophagus Dysplasia Ablation Long-term results Durability 

Notes

Funding

This research was supported by NIH Award K24DK100548 (NJS).

Compliance with Ethical Standards

Conflict of Interest

Nicholas Shaheen reports grants from Medtronic, CSA Medical, C2 Therapeutics, CDx Medical, and Interpace Diagnostics and personal fees from Pfizer and Boston Scientific.

Craig Reed declares no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Center for Esophageal Diseases and Swallowing and Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of MedicineUniversity of North Carolina School of MedicineChapel HillUSA

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