ASGE Annual Postgraduate Course at DDW: UPPER GI Only (On-Demand)

4_Sharma_BE.Detect_treat

Pdf Summary

This document discusses the detection and eradication of Barrett's esophagus (BE), a condition that can lead to esophageal cancer. The author suggests early detection of neoplastic lesions in BE patients through techniques such as high-definition endoscopy and retroflexion. Resection of early neoplastic lesions, including mucosal cancer, is recommended for treatment. The author presents data showing a 5-year recurrence rate of 14.5% for EMR (endoscopic mucosal resection) in Barrett's cancer patients.<br /><br />Mucosal ablation using techniques like radiofrequency eradication is also discussed. A systematic review and meta-analysis showed that radiofrequency ablation (RFA) had high complete eradication rates of Barrett's esophagus, with a 94.9% complete response rate. However, there were complications such as strictures and focal EMR. Hybrid APC (argon plasma coagulation) treatment is suggested as an alternative, with a study showing a complete eradication rate of 82% and low stricture rates.<br /><br />The document emphasizes the importance of early recognition and treatment of neoplasia in Barrett's esophagus for improved patient outcomes. Complications may occur but can often be managed endoscopically. The author concludes by mentioning the potential future use of artificial intelligence in detecting and treating Barrett's esophagus.<br /><br />In summary, this document highlights the significance of detecting and eradicating early neoplastic lesions in Barrett's esophagus through techniques like high-definition endoscopy and endoscopic resection. Radiofrequency ablation and hybrid APC treatment are presented as effective methods for mucosal ablation. Early recognition and treatment are crucial for better patient outcomes, and complications can be managed endoscopically. The potential role of artificial intelligence in the future of Barrett's esophagus detection and treatment is also mentioned.

Keywords

Barrett's esophagus

esophageal cancer

neoplastic lesions

high-definition endoscopy

retroflexion

endoscopic mucosal resection

mucosal ablation

radiofrequency eradication

argon plasma coagulation

artificial intelligence