ASGE Annual GI Advanced Practice Provider Course (Virtual) - Day Two | April 2022-Barrett's Esophagus and Endotherapy

Video Transcription

Video Summary

In the video, the speaker discusses Barrett's esophagus endotherapy, focusing on which patients should be treated and the differentiation between endoscopic therapy and surgery for early esophageal neoplasia or cancer. They also review the limitations of current therapeutic regimens. The speaker emphasizes the differences in the definition of Barrett's esophagus between the United States and Europe, and highlights the importance of following the pathology criteria for diagnosis. They discuss the classification of Barrett's based on the length of the segment of columnar lined epithelium, as well as the progression rate from Barrett's to esophageal carcinoma. The speaker mentions the natural history of Barrett's, including the various stages of dysplasia and carcinoma, and the need for surveillance to prevent progression to cancer. They explain the principles of endoscopic eradication therapy, including resection of visible lesions and ablation of the residual Barrett's epithelium. Different ablation techniques, such as radiofrequency ablation and cryotherapy, are discussed, as well as their indications and potential complications. The speaker also mentions the importance of ongoing surveillance after endoscopic therapy due to the risk of recurrence. They outline the indications for surgical intervention and the role of a multidisciplinary team in the management of Barrett's. The speaker concludes by highlighting the specific roles of the advanced practice providers in a Barrett's practice, including initial evaluation, peri-procedure management, facilitating tumor board discussions, and recognizing contraindications and indications for surgical referral.

Asset Subtitle

Vivek Kaul, MD, FASGE

Keywords

Barrett's esophagus endotherapy

endoscopic therapy

surgery

esophageal neoplasia

Barrett's diagnosis

progression rate

endoscopic eradication therapy

surgical intervention