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Current Treatment Options in Gastroenterology
Published in: Current Treatment Options in Gastroenterology 2/2019

01-06-2019 | Endoscopy | Endoscopy (P Siersema, Section Editor)

Durability of Endoscopic Treatment for Dysplastic Barrett’s Esophagus

Authors: Craig C. Reed, MD, MSCR, Nicholas J. Shaheen, MD, MPH

Published in: Current Treatment Options in Gastroenterology | Issue 2/2019

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Abstract

Purpose of review

This review discusses the durability of the neo-squamous esophageal epithelium following endoscopic eradication therapy of dysplastic Barrett’s esophagus. Our review will focus primarily on patients treated with radiofrequency ablation; however, we describe the known durability of cryotherapy. Additionally, we discuss the utility of novel imaging technologies and the efficacy of chemopreventive medications following endoscopic ablation.

Recent findings

Mounting data describe the durability of the post-ablation esophagus. Dysplastic Barrett’s esophagus and adenocarcinoma following ablation are rare. New data emphasize that most recurrent disease occurs in the initial year following treatment. Additionally, recent publications suggest that a much-attenuated surveillance interval may provide adequate detection of neoplasia with many fewer surveillance endoscopies.

Summary

Future guidelines will likely liberalize surveillance intervals following endoscopic eradication therapy. Additionally, further longitudinal studies will need to assess the length of time for which surveillance is indicated. The utility of chemopreventive strategies and adjunctive imaging modalities in the maintenance and surveillance of the post-ablation esophagus also remain unclear and will be areas for future investigation.
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Metadata
Title
Durability of Endoscopic Treatment for Dysplastic Barrett’s Esophagus
Authors
Craig C. Reed, MD, MSCR
Nicholas J. Shaheen, MD, MPH
Publication date
01-06-2019
Publisher
Springer US
Published in
Current Treatment Options in Gastroenterology / Issue 2/2019
Print ISSN: 1092-8472
Electronic ISSN: 1534-309X
DOI
https://doi.org/10.1007/s11938-019-00226-5

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