ASGE Endoscopy Course at ACG: Everyday Endoscopy: Expertise Meets Evidence | October 2024-Session 4: Barrett's Esophagus in 2024

Video Transcription

Video Summary

The session was a comprehensive discussion on Barrett's esophagus, primarily focusing on the best practices for surveillance, diagnosis, and treatment. Dr. Vanni Kondak, a renowned expert on esophageal diseases, highlighted the rising incidence of esophageal cancer and explained that Barrett's esophagus is a well-known precursor. The diagnosis involves both endoscopic and histologic criteria, and a structured biopsy protocol is crucial for accurate diagnosis and management. The discussion covered various aspects of surveillance using endoscopy, emphasizing the importance of the Seattle Protocol for biopsies, and the role of high-quality endoscopic practices using the "five L's" approach for assessment.<br /><br />Furthermore, there was an in-depth debate on the merits of EMR versus ESD for treating neoplastic lesions in Barrett's esophagus. The debate revolved around balancing the comprehensive tissue diagnosis and potential staging benefits of EMR, with the possibility of achieving R0 resection through ESD, crucial for effective treatment of invasive cancer. The debate included discussions on the role of new approaches and technologies like AI in improving surveillance and managing stricture risks following endoscopic resections.<br /><br />The session also touched on the implications of various surveillance intervals and risk markers such as positive P53, and concluded with practical considerations involving patient communication to ensure compliance and optimize treatments based on individual risks and lesions' characteristics.

Keywords

Barrett's esophagus

esophageal cancer

endoscopy

Seattle Protocol

EMR vs ESD

AI in surveillance

P53 risk markers

patient communication

biopsy protocol

treatment optimization