Endoscopic Mucosal Resection for Barrett’s-Related Neoplasia

  • Kumar KrishnanEmail author
  • Srinadh Komanduri


Barrett’s esophagus is the primary precursor lesion for esophageal adenocarcinoma. Historically, dysplastic Barrett’s esophagus has been treated with esophagectomy. Recent advances in endoscopic eradication techniques have resulted in minimally invasive treatments for early Barrett’s-associated neoplasia. Here, we discuss endoscopic mucosal resection techniques for Barrett’s-related neoplasia. These techniques have been demonstrated to be very safe and effective for the treatment of early neoplasia and represent a critical adjunct in the overall endoscopic management of Barrett’s esophagus.


Barrett’s esophagus Endoscopic mucosal resection Dysplasia 


  1. 1.
    Spechler SJ, Souza RF. Barrett’s esophagus. N Engl J Med. 2014;371:836–45.CrossRefGoogle Scholar
  2. 2.
    Shaheen NJ, Sharma P, Overholt BF, et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med. 2009;360:2277–88.CrossRefGoogle Scholar
  3. 3.
    Phoa KN, van Vilsteren FG, Weusten BL, et al. Radiofrequency ablation vs endoscopic surveillance for patients with Barrett esophagus and low-grade dysplasia: a randomized clinical trial. JAMA. 2014;311:1209–17.CrossRefGoogle Scholar
  4. 4.
    Shaheen NJ, Overholt BF, Sampliner RE, et al. Durability of radiofrequency ablation in Barrett’s esophagus with dysplasia. Gastroenterology. 2011;141:460–8.CrossRefGoogle Scholar
  5. 5.
    Rice TW, Zuccaro G Jr, Adelstein DJ, et al. Esophageal carcinoma: depth of tumor invasion is predictive of regional lymph node status. Ann Thorac Surg. 1998;65:787–92.CrossRefGoogle Scholar
  6. 6.
    Stein HJ, Feith M, Bruecher BL, et al. Early esophageal cancer: pattern of lymphatic spread and prognostic factors for long-term survival after surgical resection. Ann Surg. 2005;242:566–73; discussion 573–5.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Falk GW. Endoscopic ultrasound in the evaluation of Barrett’s esophagus: a preliminary report. Am J Gastroenterol. 1995;90:1187.PubMedGoogle Scholar
  8. 8.
    Spechler SJ, Sharma P, Souza RF, et al. American gastroenterological association technical review on the management of Barrett’s esophagus. Gastroenterology. 2011;140:e18–52; quiz e13.CrossRefGoogle Scholar
  9. 9.
    Pech O, May A, Manner H, et al. Long-term efficacy and safety of endoscopic resection for patients with mucosal adenocarcinoma of the esophagus. Gastroenterology. 2014;146:652–660.e1.CrossRefGoogle Scholar
  10. 10.
    Wani S, Abrams J, Edmundowicz SA, et al. Endoscopic mucosal resection results in change of histologic diagnosis in Barrett’s esophagus patients with visible and flat neoplasia: a multicenter cohort study. Dig Dis Sci. 2013;58:1703–9.CrossRefGoogle Scholar
  11. 11.
    Desai M, Saligram S, Gupta N, et al. Efficacy and safety outcomes of multimodal endoscopic eradication therapy in Barrett’s esophagus-related neoplasia: a systematic review and pooled analysis. Gastrointest Endosc. 2016;85(3):482–495.e4.CrossRefGoogle Scholar
  12. 12.
    Sharma P, Bergman JJ, Goda K, et al. Development and validation of a classification system to identify high-grade dysplasia and esophageal adenocarcinoma in Barrett’s esophagus using narrow-band imaging. Gastroenterology. 2016;150:591–8.CrossRefGoogle Scholar
  13. 13.
    Anders M, Bahr C, El-Masry MA, et al. Long-term recurrence of neoplasia and Barrett’s epithelium after complete endoscopic resection. Gut. 2014;63:1535–43.CrossRefGoogle Scholar
  14. 14.
    Chennat J, Konda VJ, Ross AS, et al. Complete Barrett’s eradication endoscopic mucosal resection: an effective treatment modality for high-grade dysplasia and intramucosal carcinoma–an American single-center experience. Am J Gastroenterol. 2009;104:2684–92.CrossRefGoogle Scholar
  15. 15.
    Li N, Pasricha S, Bulsiewicz WJ, et al. Effects of preceding endoscopic mucosal resection on the efficacy and safety of radiofrequency ablation for treatment of Barrett’s esophagus: results from the United States radiofrequency ablation registry. Dis Esophagus. 2016;29:537–43.CrossRefGoogle Scholar
  16. 16.
    Phoa KN, Pouw RE, Bisschops R, et al. Multimodality endoscopic eradication for neoplastic Barrett oesophagus: results of an European multicentre study (EURO-II). Gut. 2016;65:555–62.CrossRefGoogle Scholar
  17. 17.
    Pouw RE, van Vilsteren FG, Peters FP, et al. Randomized trial on endoscopic resection-cap versus multiband mucosectomy for piecemeal endoscopic resection of early Barrett’s neoplasia. Gastrointest Endosc. 2011;74:35–43.CrossRefGoogle Scholar
  18. 18.
    Yang D, Coman RM, Kahaleh M, et al. Endoscopic submucosal dissection for Barrett’s early neoplasia: a multicenter study in the United States. Gastrointest Endosc. 2016;86(4):600–7.CrossRefGoogle Scholar

Copyright information

© SAGES 2019

Authors and Affiliations

  1. 1.Division of GastroenterologyUnderwood Center for Digestive Disorders, Houston Methodist Hospital, Weill Cornell Medical CollegeHoustonUSA
  2. 2.Department of Internal Medicine, Division of GastroenterologyNorthwestern University, Feinberg School of MedicineChicagoUSA

Personalised recommendations