Abstract

ALIAGA RAMOS, Josué Jesus  and  ARANTES, Vitor. Barrett's esophagus with high grade dysplasia or intramucosal adenocarcinoma: EMR or ESD?. Rev. gastroenterol. Perú [online]. 2019, vol.39, n.3, pp.265-272. ISSN 1022-5129.

Barrett’s esophagus (BE) is a relatively common clinical entity with an important impact on the quality of life of these patients. The incidence of this pathology has been increasing in recent years due to an increase in the occurrence of predisposing factors such as gastroesophageal reflux disease. BE carries an oncogenic potential with the development of dysplasia or esophageal adenocarcinoma. Thus, endoscopic surveillance is recommended to BE patients, aiming to detect neoplastic transformation in an early stage, enabling less invasive therapeutic options like endoscopic resection as the first line of therapy. One of the most controversial issues in the recent management of Barrett’s esophagus complicated by a pre-neoplastic or early neoplastic lesion is the technique of endoscopic approach: endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). This question is extremely important because a complete endoscopic resection (R0) regardless of the technique utilized significantly reduces local recurrence rate, improving survival in the medium and long term. The objective of this article is to review the most important studies published about this topic, in order to better understand which endoscopic therapeutic procedure of the aforementioned (EMR or ESD) may lead to better clinical outcome for this type of lesions in patients with Barrett’s esophagus.

Keywords : Barrett esophagus; Adenocarcinoma; Endoscopic mucosal resection.

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