ASGE Esophagology General GI Practice Virtual Program (LIVE Virtual) | April 2021-Esophageal Endoscopic Submucosal Dissection in the West

Video Transcription

Video Summary

Dr. Peter Dragunov from the University of Florida discusses the management of Barrett's esophagus using endoscopic procedures in a video presentation. He explains that previously, patients with Barrett's and high-grade dysplasia had to undergo surgery, but now endoscopy can successfully manage the majority of cases. The current algorithm involves using endoscopic mucosal resection to remove visible irregularities and radiofrequency ablation to treat the remaining flat Barrett's epithelium. However, the accuracy of pre-procedure staging tools is limited, with multiple tests available but none being perfect. There is also a high recurrence rate with the current algorithm. Dr. Dragunov highlights the advantages of endoscopic submucosal dissection (ESD) compared to piecemeal EMR, as ESD provides better specimens for evaluation. He discusses studies showing discordance in histological evaluation between EMR and ESD specimens, influencing treatment decisions. He presents data supporting ESD as a staging procedure and compares the clinical outcomes of EMR versus ESD, demonstrating the superiority of ESD in terms of unblocked resection rates and curative resection. Dr. Dragunov concludes by summarizing the indications for ESD in Barrett's esophagus as outlined by the American Gastroenterologic Association. No credits were given in the video.

Asset Subtitle

Peter Draganov

Keywords

Barrett's esophagus

endoscopic procedures

endoscopic mucosal resection

radiofrequency ablation

endoscopic submucosal dissection