Skip to main content

Advertisement

SpringerLink
Log in

Endoscopic Management of Barrett’s Esophagus: Advances in Endoscopic Techniques

  • Review
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Barrett’s esophagus (BE) is a well-known premalignant condition that can be associated with the development of dysplasia and adenocarcinoma. In the past, esophagectomy was the standard treatment for patients with BE with high grade dysplasia (HGD) and early cancer (EC). However, esophagectomy is not necessarily the only treatment response to HGD and EC anymore. Over the past decade, a number of endoscopic therapies have been developed for management of BE. These include endoscopic mucosal resection, thermal ablation techniques that use laser irradiation, multipolar electrocoagulation, argon plasma coagulation, photodynamic therapy, and the recently developed cryotherapy and radiofrequency ablation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Barrett NR. Chronic peptic ulcer of the esophagus and ‘oesophagitis’. Br J Surg. 1950;38:175–182.

    Article  PubMed  CAS  Google Scholar 

  2. Lagergren J, Bergstrom R, Lindgren A, Nyren O. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med. 1999;340:825–831.

    Article  PubMed  CAS  Google Scholar 

  3. Van Sandick JW, van Lanschot JJ, Kuiken BW, Tytgat GN, Offerhaus GJ, Obertop H. Impact of endoscopic biopsy surveillance of Barrett’s oesophagus on pathological stage and clinical outcome of Barrett’s carcinoma. Gut. 1998;43:216–222.

    Article  PubMed  Google Scholar 

  4. Pohl H, Welch HG. The role of overdiagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence. J Natl Cancer Inst. 2005;97:142–146.

    Article  PubMed  Google Scholar 

  5. Rastogi A, Puli S, El-Serag HB, Bansal A, Wani S, Sharma P. Incidence of esophageal adenocarcinoma in patients with Barrett’s esophagus and high-grade dysplasia: a meta-analysis. Gastrointest Endosc. 2008;67:394–398.

    Article  PubMed  Google Scholar 

  6. Jensen FH, Pedersen L, Drewes AM, Sorensen HT, Jensen PF. Incidence of adenocarcimoa among patients with Barrett’s esophagus. N Engl J Med. 2011;365:1375–1383.

    Article  Google Scholar 

  7. Schnell TG, Sontag SJ, Chejfec G, et al. Long-term nonsurgical management of Barrett’s esophagus with high-grade dysplasia. Gastroenterology. 2001;120:1607–1619.

    Article  PubMed  CAS  Google Scholar 

  8. Heitmiller RF, Redmond M, Hamilton SR. Barrett’s esophagus with high-grade dysplasia. An indication for prophylactic esophagectomy. Ann Surg. 1996;224:66–71.

    Article  PubMed  CAS  Google Scholar 

  9. Sharma P. Controversies in Barrett’s esophagus: management of high grade dysplasia. Semin Gastrointest Dis. 2001;12:26–32.

    PubMed  CAS  Google Scholar 

  10. Ruol A, Zaninotto G, Costantini M, et al. Barrett’s esophagus: management of high-grade dysplasia and cancer. J Surg Res. 2004;117:44–51.

    Article  PubMed  Google Scholar 

  11. Korst RJ, Altorki NK. High grade dysplasia: surveillance, mucosal ablation, or resection? World J Surg. 2003;27:1030–1034.

    Article  PubMed  Google Scholar 

  12. Pera M, Trastek VF, Carpenter HA, Allen MS, Deschamps C, Pairolero PC. Barrett’s esophagus with high-grade dysplasia: an indication for esophagectomy? Ann Thorac Surg. 1992;54:199–204.

    Article  PubMed  CAS  Google Scholar 

  13. Edwards MJ, Gable DR, Lentsch AB, Richardson JD. The rationale for esophagectomy as the optimal therapy for Barrett’s esophagus with high-grade dysplasia. Ann Surg. 1996;223:585–589; discussion 589–591.

    Google Scholar 

  14. Konda VJ, Ross AS, Ferguson MK, et al. Is the risk of concomitant invasive esophageal cancer in high-grade dysplasia in Barrett’s esophagus overestimated? Clin Gastroenterol Hepatol. 2008;6:159–164.

    Article  PubMed  Google Scholar 

  15. Collard JM. High-grade dysplasia in Barrett’s esophagus. The case for esophagectomy. Chest Surg Clin N Am. 2002;12:77–92.

    Article  PubMed  Google Scholar 

  16. Falk GW, Rice TW, Goldblum JR, Richter JE. Jumbo biopsy forceps protocol still misses unsuspected cancer in Barrett’s esophagus with high-grade dysplasia. Gastrointest Endosc. 1999;49:170–176.

    Article  PubMed  CAS  Google Scholar 

  17. Hulscher JB, van Sandick JW, de Boer AG, et al. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med. 2002;347:1662–1669.

    Article  PubMed  Google Scholar 

  18. Stein HJ, Hutter J, Feith M, von Rahden BH. Limited surgical resection and jejunal interposition for early adenocarcinoma of the distal esophagus. Semin Thorac Cardiovasc Surg. 2007;19:72–78.

    Article  PubMed  Google Scholar 

  19. Banki F, Mason RJ, DeMeester SR, et al. Vagal-sparing esophagectomy: a more physiologic alternative. Ann Surg. 2002;236:324–335; discussion 335–336.

    Google Scholar 

  20. Schembre DB, Huang JL, Lin OS, Cantone N, Low DE. Treatment of Barrett’s esophagus with early neoplasia: a comparison of endoscopic therapy and esophagectomy. Gastrointest Endosc. 2008;67:595–601.

    Article  PubMed  Google Scholar 

  21. O’Riordan JM, Tucker ON, Byrne PJ, et al. Factors influencing the development of Barrett’s epithelium in the esophageal remnant postesophagectomy. Am J Gastroenterol. 2004;99:205–211.

    Article  PubMed  Google Scholar 

  22. Pohl H, Sonnenberg A, Strobel S, et al. Endoscopic versus surgical therapy for early cancer in Barrett's esophagus: a decision analysis. GIE. 2009;70:623–631.

    Google Scholar 

  23. Stein HJ, Feith M, Mueller J, Werner M, Siewert JR. Limited resection for early adenocarcinoma in Barrett’s esophagus. Ann Surg. 2000;232:733–742.

    Article  PubMed  CAS  Google Scholar 

  24. Holscher AH, Bollschweiler E, Schneider PM, Siewert JR. Early adenocarcinoma in Barrett’s oesophagus. Br J Surg. 1997;84:1470–1473.

    Article  PubMed  CAS  Google Scholar 

  25. Feith M, Stein HJ, Siewert JR. Pattern of lymphatic spread of Barrett’s cancer. World J Surg. 2003;27:1052–1057.

    Article  PubMed  Google Scholar 

  26. Sharma P, Falk GW, Sampliner R, Jon Spechler S, Wang K. Management of nondysplastic Barrett’s esophagus: where are we now? Am J Gastroenterol. 2009;104:805–808.

    Article  PubMed  Google Scholar 

  27. Choudhary A, Szary NM, Kuwajima VK, et al. Endoscopic interventions for Barrett's esophagus with low-grade dysplasia to prevent progression: a meta-analysis of randomized controlled trials. Gastrointest Endosc. 2010;71:AB173–AB174.

    Article  Google Scholar 

  28. Wani S, Puli SR, Shaheen NJ, et al. Esophageal adenocarcinoma in Barrett’s esophagus after endoscopic ablative therapy: a meta-analysis and systematic review. Am J Gastroenterol. 2009;104:502–513.

    Article  PubMed  Google Scholar 

  29. Sharma P, Falk GW, Weston AP, Reker D, Johnston M, Sampliner RE. Dysplasia and cancer in a large multicenter cohort of patients with Barrett’s esophagus. Clin Gastroenterol Hepatol. 2006;4:566–572.

    Article  PubMed  Google Scholar 

  30. Montgomery E, Bronner MP, Goldblum JR, et al. Reproducibility of the diagnosis of dysplasia in Barrett esophagus: a reaffirmation. Hum Pathol. 2001;32:368–378.

    Article  PubMed  CAS  Google Scholar 

  31. Shaheen NJ, Sharma P, Overholt BF, et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med. 2009;360:2277–2288.

    Article  PubMed  CAS  Google Scholar 

  32. Inadomi JM, Somsouk M, Madanick RD, Thomas JP, Shaheen NJ. A cost-utility analysis of ablative therapy for Barrett’s esophagus. Gastroenterology. 2009;136:2101–2114.

    Article  PubMed  Google Scholar 

  33. Hemminger LL, Panossian AM, Duran C, et al. Procedural trends in endoscopic ablation and resection for esophageal dysplasia and carcinoma. Gastrointest Endosc. 2010;71:AB178.

    Article  Google Scholar 

  34. Wang K. Endoscopic treatment for Barrett's esophagus and early esophageal cancer. J Gastrointest Surg. 2010;14:946–947.

    Article  PubMed  Google Scholar 

  35. Ell C, May A, Gossner L, et al. Endoscopic mucosal resection of early cancer and high-grade dysplasia in Barrett’s esophagus. Gastroenterology. 2000;118:670–677.

    Article  PubMed  CAS  Google Scholar 

  36. Ciocirlan M, Lapalus MG, Hervieu V, et al. Endoscopic mucosal resection for squamous premalignant and early malignant lesions of the esophagus. Endoscopy. 2007;39:24–29.

    Article  PubMed  CAS  Google Scholar 

  37. May A, Gossner L, Pech O, et al. Local endoscopic therapy for intraepithelial high-grade neoplasia and early adenocarcinoma in Barrett’s oesophagus: acute-phase and intermediate results of a new treatment approach. Eur J Gastroenterol Hepatol. 2002;14:1085–1091.

    Article  PubMed  Google Scholar 

  38. Ell C, May A, Pech O, et al. Curative endoscopic resection of early esophageal adenocarcinomas (Barrett’s cancer). Gastrointest Endosc. 2007;65:3–10.

    Article  PubMed  Google Scholar 

  39. Esaki M, Matsumoto T, Hirakawa K, et al. Risk factors for local recurrence of superficial esophageal cancer after treatment by endoscopic mucosal resection. Endoscopy. 2007;39:41–45.

    Article  PubMed  CAS  Google Scholar 

  40. Giovannini M, Bories E, Pesenti C, et al. Circumferential endoscopic mucosal resection in Barrett’s esophagus with high-grade intraepithelial neoplasia or mucosal cancer. Preliminary results in 21 patients. Endoscopy. 2004;36:782–787.

    Article  PubMed  CAS  Google Scholar 

  41. Peters FP, Kara MA, Rosmolen WD, et al. Endoscopic treatment of high-grade dysplasia and early stage cancer in Barrett’s esophagus. Gastrointest Endosc. 2005;61:506–514.

    Article  PubMed  Google Scholar 

  42. Buttar NS, Wang KK, Lutzke LS, Krishnadath KK, Anderson MA. Combined endoscopic mucosal resection and photodynamic therapy for esophageal neoplasia within Barrett’s esophagus. Gastrointest Endosc. 2001;54:682–688.

    PubMed  CAS  Google Scholar 

  43. May A, Gossner L, Pech O, et al. Intraepithelial high-grade neoplasia and early adenocarcinoma in short-segment Barrett’s esophagus (SSBE): curative treatment using local endoscopic treatment techniques. Endoscopy. 2002;34:604–610.

    Article  PubMed  CAS  Google Scholar 

  44. Manner H, May A, Pech O, et al. Early Barrett’s carcinoma with “low-risk” submucosal invasion: long-term results of endoscopic resection with a curative intent. Am J Gastroenterol. 2008;103:2589–2597.

    Article  PubMed  Google Scholar 

  45. Sharma P, Jaffe PE, Bhattacharyya A, Sampliner RE. Laser and multipolar electrocoagulation ablation of early Barrett’s adenocarcinoma: long-term follow-up. Gastrointest Endosc. 1999;49:442–1446.

    Article  PubMed  CAS  Google Scholar 

  46. Dulai GS, Jensen DM, Cortina G, Fontana L, Ippoliti A. Randomized trial of argon plasma coagulation vs. multipolar electrocoagulation for ablation of Barrett’s esophagus. Gastrointest Endosc. 2005;61:232–240.

    Article  PubMed  Google Scholar 

  47. Barham CP, Jones RL, Biddlestone LR, Hardwick RH, Shepherd NA, Barr H. Photothermal laser ablation of Barrett’s oesophagus: endoscopic and histological evidence of squamous re-epithelialisation. Gut. 1997;41:281–284.

    Article  PubMed  CAS  Google Scholar 

  48. Weston AP, Sharma P. Neodymium:yttrium-aluminum garnet contact laser ablation of Barrett’s high grade dysplasia and early adenocarcinoma. Am J Gastroenterol. 2002;97:2998–3006.

    Article  PubMed  Google Scholar 

  49. Schulz H, Miehlke S, Antos D, et al. Ablation of Barrett’s epithelium by endoscopic argon plasma coagulation in combination with high-dose omeprazole. Gastrointest Endosc. 2000;51:659–663.

    PubMed  CAS  Google Scholar 

  50. Attwood SE, Lewis CJ, Caplin S, Hemming K, Armstrong G. Argon beam plasma coagulation as therapy for high-grade dysplasia in Barrett’s esophagus. Clin Gastroenterol Hepatol. 2003;1:258–263.

    Article  PubMed  Google Scholar 

  51. May A, Gossner L, Gunter E, Stolte M, Ell C. Local treatment of early cancer in short Barrett’s esophagus by means of argon plasma coagulation: initial experience. Endoscopy. 1999;31:497–500.

    Article  PubMed  CAS  Google Scholar 

  52. Pereira-Lima JC, Busnello JV, Saul C, et al. High power setting argon plasma coagulation for the eradication of Barrett’s esophagus. Am J Gastroenterol. 2000;95:1661–1668.

    Article  PubMed  CAS  Google Scholar 

  53. Morris CD, Byrne JP, Armstrong GR, Attwood SE. Prevention of the neoplastic progression of Barrett’s oesophagus by endoscopic argon beam plasma ablation. Br J Surg. 2001;88:1357–1362.

    Article  PubMed  CAS  Google Scholar 

  54. Byrne JP, Armstrong GR, Attwood SE. Restoration of the normal squamous lining in Barrett’s esophagus by argon beam plasma coagulation. Am J Gastroenterol. 1998;93:1810–1815.

    Article  PubMed  CAS  Google Scholar 

  55. Pedrazzani C, Catalano F, Festini M, et al. Endoscopic ablation of Barrett’s esophagus using high power setting argon plasma coagulation: a prospective study. World J Gastroenterol. 2005;11:1872–1875.

    PubMed  Google Scholar 

  56. Pinotti AC, Cecconello I, Filho FM, Sakai P, Gama-Rodrigues JJ, Pinotti HW. Endoscopic ablation of Barrett’s esophagus using argon plasma coagulation: a prospective study after fundoplication. Dis Esophagus. 2004;17:243–246.

    Article  PubMed  CAS  Google Scholar 

  57. Van Laethem JL, Cremer M, Peny MO, Delhaye M, Deviere J. Eradication of Barrett’s mucosa with argon plasma coagulation and acid suppression: immediate and mid term results. Gut. 1998;43:747–751.

    Article  PubMed  Google Scholar 

  58. Van Laethem JL, Jagodzinski R, Peny MO, Cremer M, Deviere J. Argon plasma coagulation in the treatment of Barrett’s high-grade dysplasia and in situ adenocarcinoma. Endoscopy. 2001;33:257–261.

    Article  PubMed  Google Scholar 

  59. Johnston MH, Eastone JA, Horwhat JD, Cartledge J, Mathews JS, Foggy JR. Cryoablation of Barrett’s esophagus: a pilot study. Gastrointest Endosc. 2005;62:842–848.

    Article  PubMed  Google Scholar 

  60. Kerstetter DL, H F. Endoscopic cryoablation of Barrett’s with high grade dysplasia: a single center case series. Gastrointest Endosc. 2009;69:AB260–AB261.

  61. Shaheen NJ, Greenwald BD, Dumot JA, et al. Safety and efficacy of endoscopic spray cryotherapy for Barrett’s esophagus with high grade dysplasia. Gastrointest Endosc. 2009;69:AB357.

    Article  Google Scholar 

  62. Canto MI, Gorospe EC, Shin EJ. Carbon dioxide (CO2) cryotherapy is a safe and effective treatment of Barrett’s esophagus (BE) with HGD/intramucosal carcinoma. Gastrointest Endosc. 2009;69:AB341.

    Article  Google Scholar 

  63. Flores A, G RS, Chung DS, et al. Barrett’s esophagus eradication by radiofrequency and cryoablation. Gastrointest Endosc. 2009;69:AB256.

    Google Scholar 

  64. Wolfsen HC. Present status of photodynamic therapy for high-grade dysplasia in Barrett’s esophagus. J Clin Gastroenterol. 2005;39:189–202.

    Article  PubMed  Google Scholar 

  65. Overholt BF, Lightdale CJ, Wang KK, et al. Photodynamic therapy with porfimer sodium for ablation of high-grade dysplasia in Barrett’s esophagus: international, partially blinded, randomized phase III trial. Gastrointest Endosc. 2005;62:488–498.

    Article  PubMed  Google Scholar 

  66. Overholt BF, Wang KK, Burdick JS, et al. Five-year efficacy and safety of photodynamic therapy with photofrin in Barrett’s high-grade dysplasia. Gastrointest Endosc. 2007;66:460–468.

    Article  PubMed  Google Scholar 

  67. Overholt BF, Panjehpour M, Haydek JM. Photodynamic therapy for Barrett’s esophagus: follow-up in 100 patients. Gastrointest Endosc. 1999;49:1–7.

    Article  PubMed  CAS  Google Scholar 

  68. Hage M, Siersema PD, van Dekken H, et al. 5-aminolevulinic acid photodynamic therapy versus argon plasma coagulation for ablation of Barrett’s oesophagus: a randomised trial. Gut. 2004;53:785–790.

    Article  PubMed  CAS  Google Scholar 

  69. Pech O, Gossner L, May A, et al. Long-term results of photodynamic therapy with 5-aminolevulinic acid for superficial Barrett’s cancer and high-grade intraepithelial neoplasia. Gastrointest Endosc. 2005;62:24–30.

    Article  PubMed  Google Scholar 

  70. Van Laethem JL, Peny MO, Salmon I, Cremer M, Deviere J. Intramucosal adenocarcinoma arising under squamous re-epithelialisation of Barrett’s oesophagus. Gut. 2000;46:574–577.

    Article  PubMed  Google Scholar 

  71. Sharma VK, Wang KK, Overholt BF, et al. Balloon-based, circumferential, endoscopic radiofrequency ablation of Barrett’s esophagus: 1-year follow-up of 100 patients. Gastrointest Endosc. 2007;65:185–195.

    Article  PubMed  Google Scholar 

  72. Chennat J, Ross AS, Konda VJ, et al. Advanced pathology under squamous epithelium on initial EMR specimens in patients with Barrett's esophagus and high-grade dysplasia or intramucosal carcinoma: implications for surveillance and endotherapy management. Gastrointest Endosc. 2009;70:417–421.

    Article  PubMed  Google Scholar 

  73. Ganz RA, Utley DS, Stern RA, Jackson J, Batts KP, Termin P. Complete ablation of esophageal epithelium with a balloon-based bipolar electrode: a phased evaluation in the porcine and in the human esophagus. Gastrointest Endosc. 2004;60:1002–1010.

    Article  PubMed  Google Scholar 

  74. Gossner L, May A, Stolte M, Seitz G, Hahn EG, Ell C. KTP laser destruction of dysplasia and early cancer in columnar-lined Barrett’s esophagus. Gastrointest Endosc. 1999;49:8–12.

    Article  PubMed  CAS  Google Scholar 

  75. Ragunath K, Krasner N, Raman VS, Haqqani MT, Phillips CJ, Cheung I. Endoscopic ablation of dysplastic Barrett’s oesophagus comparing argon plasma coagulation and photodynamic therapy: a randomized prospective trial assessing efficacy and cost-effectiveness. Scand J Gastroenterol. 2005;40:750–758.

    Article  PubMed  Google Scholar 

  76. Vargo JJ. Clinical applications of the argon plasma coagulator. Gastrointest Endosc. 2004;59:81–88.

    Article  PubMed  Google Scholar 

  77. Manner H, Rabenstein T, Braun K, et al. What should we do with the remainder of the Barrett’s segment after endoscopic resection of early Barrett’s cancer? Gastrointest Endosc. 2010;71:AB175.

    Google Scholar 

  78. Dumot JA. Successful training in gastrointestinal endoscopy. Gastrointest Endosc. 2009;70:635–644.

    Google Scholar 

  79. Greenwald BD. Endoscopic spray cryotherapy for esophageal cancer: safety and efficacy. Gastrointest Endosc. 2010;71:686–693.

    Article  PubMed  Google Scholar 

  80. Sreenarasimhaiah J, Singh S. Utility of endoscopic ultrasound to determine the depth of cryospray ablation therapy in dysplastic Barrett’s esophagus. Gastrointest Endosc. 2010;71:AB315.

    Article  Google Scholar 

  81. Ortner MA, Zumbusch K, Liebetruth J, et al. Is topical delta-aminolevulinic acid adequate for photodynamic therapy in Barrett’s esophagus? A pilot study. Endoscopy. 2002;34:611–616.

    Article  PubMed  Google Scholar 

  82. Grant WE, Hopper C, MacRobert AJ, Speight PM, Bown SG. Photodynamic therapy of oral cancer: photosensitisation with systemic aminolaevulinic acid. Lancet. 1993;342:147–148.

    Article  PubMed  CAS  Google Scholar 

  83. Prosst RL, Wolfsen HC, Gahlen J. Photodynamic therapy for esophageal diseases: a clinical update. Endoscopy. 2003;35:1059–1068.

    Article  PubMed  CAS  Google Scholar 

  84. Sanchez A, Reza M, Blasco AJ, Callejo D. Effectiveness, safety, and cost-effectiveness of photodynamic therapy in BE: a systemic review. Dis Esophagus. 2010;23:633–640.

    Article  PubMed  CAS  Google Scholar 

  85. Prasad GA, Wang KK, Buttar NS, et al. Long-term survival following endoscopic and surgical treatment of high-grade dysplasia in Barrett’s esophagus. Gastroenterology. 2007;132:1226–1233.

    Article  PubMed  Google Scholar 

  86. Prasad GA, Wang KK, Buttar NS, Wongkeesong LM, Lutzke LS, Borkenhagen LS. Predictors of stricture formation after photodynamic therapy for high-grade dysplasia in Barrett’s esophagus. Gastrointest Endosc. 2007;65:60–66.

    Article  PubMed  Google Scholar 

  87. Vij R, Triadafilopoulos G, Owens DK, Kunz P, Sanders GD. Cost-effectiveness of photodynamic therapy for high-grade dysplasia in Barrett’s esophagus. Gastrointest Endosc. 2004;60:739–756.

    Article  PubMed  Google Scholar 

  88. Overholt B, Dean P, Galanko J, Lightdale C. Does Ablative therapy for BE affect the depth of subsequent esophageal biopsy as compared with controls. J Clin Gastroenterol. 2010;44:676–681.

    Article  PubMed  Google Scholar 

  89. Hubbard N, Velanovich V. Endoscopic endoluminal radiofrequency ablation of Barrett’s esophagus in patients with fundoplications. Surg Endosc. 2007;21:625–628.

    Article  PubMed  CAS  Google Scholar 

  90. Roorda AK, Marcus SN, Triadafilopoulos G. Early experience with radiofrequency energy ablation therapy for Barrett’s esophagus with and without dysplasia. Dis Esophagus. 2007;20:516–522.

    Article  PubMed  CAS  Google Scholar 

  91. Hernandez JC, T F, Reicher S, et al. Frequency of buried Barrett’s metaplasia after BARRX ablation for intestinal metaplasia with or without dysplasia. GIE. 2007; 65:AB11.

    Google Scholar 

  92. Sharma V, K H, Mclaughlin R, et al. Successful circumferential ablation of Barrett’s esophagus (BE) with low grade dysplasia (LGD) using the HALO-360 ablation system: one-year follow-up of the AIM-LGD pilot trial. Gastrointest Endosc. 2006;63:AB127.

    Google Scholar 

  93. Smith CD, Bejarano PA, Melvin WS, Patti MG, Muthusamy R, Dunkin BJ. Endoscopic ablation of intestinal metaplasia containing high-grade dysplasia in esophagectomy patients using a balloon-based ablation system. Surg Endosc. 2007;21:560–569.

    Article  PubMed  CAS  Google Scholar 

  94. Ganz R, Overholt G, Panjehpour M, et al. Treatment of Barrett’s esophagus and high-grade dysplasia using the HALO-360 ablation system: a multi-center experience. Gastrointest Endosc. 2006;63:AB124.

    Article  Google Scholar 

  95. Gondrie JJ, P F, Curvers WL, et al. Radiofrequency ablation of Barrett’s esophagus containing high-grade dysplasia. Gastrointest Endosc. 2007;65:AB135.

    Article  Google Scholar 

  96. Pouw RE, Gondrie JJ, Sondermeijer C, et al. Novel combined modality therapy for Barrett’s esophagus containing high-grade dysplasia: endoscopic mucosal resection followed by circumferential and focal ablation using the HALO system. Gastrointest Endosc. 2007;65:AB111.

    Article  Google Scholar 

  97. Shaheen NJ, S P, Overholt BF, Linghtdale CJ, Wolfsen HC, Sampliner RE. A randomized, multicenter, sham-controlled trial of radiofrequency ablation (RFA) for subjects with Barrett’s esophagus (BE) containing dysplasia: interim results of the aim dysplasia trial. Gastroenterology. 2008;134:A-37.

    Article  Google Scholar 

  98. Ganz RA, Overholt BF, Sharma VK, et al. Circumferential ablation of Barrett’s esophagus that contains high-grade dysplasia: a U.S. Multicenter Registry. Gastrointest Endosc. 2008;68:35–40.

    Article  PubMed  Google Scholar 

  99. Fleischer D, Overholt B, Sharma V, Reymunde A, Kimmey M, et al. Endoscopic radiofrequency ablation for Barrett’s esophagus. Gastrointest Endosc. 2010;71:AB117.

    Article  Google Scholar 

  100. Dunkin BJ, Martinez J, Bejarano PA, et al. Thin-layer ablation of human esophageal epithelium using a bipolar radiofrequency balloon device. Surg Endosc. 2006;20:125–130.

    Article  PubMed  CAS  Google Scholar 

  101. Ackroyd R, Tam W, Schoeman M, Devitt PG, Watson DI. Prospective randomized controlled trial of argon plasma coagulation ablation vs. endoscopic surveillance of patients with Barrett’s esophagus after antireflux surgery. Gastrointest Endosc. 2004;59:1–7.

    Article  PubMed  Google Scholar 

  102. Sampliner RE. Endoscopic ablative therapy for Barrett’s esophagus: current status. Gastrointest Endosc. 2004;59:66–69.

    Article  PubMed  Google Scholar 

  103. Gondrie JJ, R A, Sondermeijer C, et al. Balloon-based circumferential ablation followed by focal ablation of Barrett’s esophagus containing high grade dysplasia effectively removes all genetic alterations. Gastroenterology. 2007;132:A-64.

    Google Scholar 

  104. Krishnadath KK, Wang KK, Taniguchi K, et al. Persistent genetic abnormalities in Barrett’s esophagus after photodynamic therapy. Gastroenterology. 2000;119:624–630.

    Article  PubMed  CAS  Google Scholar 

  105. Watson T. Radiofrequency ablation of BE. J Gastrointest Surg. 2010;14:S88–S93.

    Article  PubMed  Google Scholar 

  106. Lyday W. Radiofrequency ablation of Barrett's esophagus: outcomes of 429 patients from a multicenter community practice registry. Endoscopy. 2010;42:272–278.

    Article  PubMed  CAS  Google Scholar 

  107. Inadomi J, Somsouk M, Madanick RD, Thomas JP, Shaheen NJ. A cost utility analysis of ablative therapy for BE. Gastroenterology. 2009;136:2101–2114, e1–6.

    Google Scholar 

  108. Shinoura S, Chang K, Iwashita T, Lee J, Mathusamy R. Are there factors that predict which patients undergoing radiofrequency ablation of Barrett’s esophagus will require prolonged ablation therapy? Gastrointest Endosc. 2010;71:AB172.

    Article  Google Scholar 

  109. Leao P, Goers T, Pierce R, Dunst C, Swanstrom L. Short term outcome of concomitant antireflux surgery with BARRx ablation for Barrett’s esophagus. Gastrointest Endosc. 2010;71:AB178.

    Article  Google Scholar 

  110. Vaccaro B, Gonzalez S, Abrams J, et al. Detection of Barrett’s esophagus after initial complete response with radiofrequency ablation. Gastrointest Endosc. 2010;71:AB182.

    Article  Google Scholar 

  111. Seewald S, Ang TL, Gotoda T, Soehendra N. Total endoscopic resection of Barrett esophagus. Endoscopy. 2008;40:1016–1020.

    Article  PubMed  CAS  Google Scholar 

  112. Kantsevoy SV, Adler DG, Conway JD, et al. Endoscopic mucosal resection and endoscopic submucosal dissection. Gastrointest Endosc. 2008;68:11–18.

    Article  PubMed  Google Scholar 

  113. Pech O, Behrens A, May A, et al. Long-term results and risk factor analysis for recurrence after curative endoscopic therapy in 349 patients with high-grade intraepithelial neoplasia and mucosal adenocarcinoma in Barrett’s oesophagus. Gut. 2008;57:1200–1206.

    Article  PubMed  CAS  Google Scholar 

  114. Herrero LA, Pouw RE, Weusten BL, Bergman J. Multi-band mucosectomy in Barrett’s esophagus: a prospective registration of 1,060 resections in 243 procedures. Gastrointest Endosc. 2010;71:AB127.

    Article  Google Scholar 

  115. Sayana H, W S, Keighley JD, et al. Endoscopic mucosal resection (EMR) as a diagnostic tool in Barrett’s esophagus (BE) patients with high-grade dysplasia (HGD) and early esophageal adenocarcinoma (EAC): a systematic review. Gastroenterology. 2008;134:A-724.

    Article  Google Scholar 

  116. Shami VM, Villaverde A, Stearns L, et al. Clinical impact of conventional endosonography and endoscopic ultrasound-guided fine-needle aspiration in the assessment of patients with Barrett’s esophagus and high-grade dysplasia or intramucosal carcinoma who have been referred for endoscopic ablation therapy. Endoscopy. 2006;38:157–161.

    Article  PubMed  CAS  Google Scholar 

  117. Pouw R. Efficacy of RFA combined with endoscopic resection for BE with early neoplasia. Clin J Gastroenterol Hepatol. 2010;8:23–29.

    Article  Google Scholar 

  118. Lopes CV, Hela M, Pesenti C, et al. Circumferential endoscopic resection of Barrett’s esophagus with high-grade dysplasia or early adenocarcinoma. Surg Endosc. 2007;21:820–824.

    Article  PubMed  CAS  Google Scholar 

  119. Soehendra N, Seewald S, Groth S, et al. Use of modified multiband ligator facilitates circumferential EMR in Barrett’s esophagus (with video). Gastrointest Endosc. 2006;63:847–852.

    Article  PubMed  Google Scholar 

  120. Lewis J, Rubenstein J, Singal A, Piraka C. Factors associated with esophageal stricture development following endoscopic mucosal resection for neoplastic Barrett’s esophagus. Gastrointest Endosc. 2010;71:AB324.

    Article  Google Scholar 

  121. Kakushima N, Yahagi N, Fujishiro M, Kodashima S, Nakamura M, Omata M. Efficacy and safety of endoscopic submucosal dissection for tumors of the esophagogastric junction. Endoscopy. 2006;38:170–174.

    Article  PubMed  CAS  Google Scholar 

  122. Deprez P, Piessevaux H, Aouattah T, Yeung R, Sempoux C, Jouret-Mourin A. ESD in Barrett’s esophagus, high grade dysplasia and mucosal cancer. Gastrointest Endosc. 2010;71:AB126.

    Article  Google Scholar 

  123. Pouw R, Bisschops R, Pech O, Ragunath K, Weusten B, et al. Safety outcome of balloon-based circumferential radiofrequency ablation after focal endoscopic resection of early Barrett’s neoplasia in 118 patients. Gastrointest Endosc. 2010;71:AB126.

    Article  Google Scholar 

  124. Spechler SJ, Sharma P, Souza R, et al. American Gastroenterological Association medical position statement on the management of Barrett’s esophagus. Gastroenterology. 2011;140:1084–1091.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors have no disclosures to make. The authors deny any conflicts of interest or ethical adherence.

Author information

Authors and Affiliations

  1. State University of New York at Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA

    Ali Azarm, Ismet Lukolic, Meenal Shukla, Ronald Concha-Parra & Frank Gress

  2. 275 Linden Boulevard, A-10, Brooklyn, NY, 11226, USA

    Ismet Lukolic

Authors
  1. Ali Azarm
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ismet Lukolic
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Meenal Shukla
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ronald Concha-Parra
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Frank Gress
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ismet Lukolic.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Azarm, A., Lukolic, I., Shukla, M. et al. Endoscopic Management of Barrett’s Esophagus: Advances in Endoscopic Techniques. Dig Dis Sci 57, 3055–3064 (2012). https://doi.org/10.1007/s10620-012-2279-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-012-2279-0

Keywords

Search

Navigation