| Theme |
Diagnosis and Treatment of Barrett's Esophagus : up-to-date |
| Title |
Endoscopic Treatment of Barrett's Esophagus and Early Esophageal Adenocarcinoma |
| Author |
Masayoshi Yamada |
Endoscopy Division, National Cancer Center Hospital |
| Author |
Ichiro Oda |
Endoscopy Division, National Cancer Center Hospital |
| Author |
Seiichiro Abe |
Endoscopy Division, National Cancer Center Hospital |
| Author |
Hiroyasu Igaki |
Esophageal Surgery Division, National Cancer Center Hospital |
| Author |
Yuji Tachimori |
Esophageal Surgery Division, National Cancer Center Hospital |
| Author |
Ryoji Kushima |
Department of Pathology and Clinical Laboratories, National Cancer Center Hospital |
| [ Summary ] |
In Japan, short-segment Barrett's esophagus (SSBE) is commonly associated with esophageal adenocarcinoma. A number of studies have previously demonstrated the safety and effectiveness of endoscopic resection. From our study we determined location of the central part of the tumor within the esophagus is also an important factor for predicting lymph node metastasis, as well as lymphovascular involvement and depth of invasion. Endoscopists should be cognizant of the likelihood of esophageal stenosis when endoscopic submucosal dissection (ESD) results in a mucosal defect of 3/4 or more of the esophageal circumference. In Western countries, endoscopic mucosal resection (EMR) followed by radiofrequency ablation (RFA) therapy facilitates successful treatment of Barrett's esophagus with high-grade dysplasia and intramucosal adenocarcinoma. In Japan, most of the area involved with Barrett's esophagus is resected during ESD for adenocarcinoma. Therefore, indications for RFA for residual Barrett's esophagus after ESD in patients with SSBE and associated esophageal adenocarcinoma are still controversial. |