Buried Barrett Metaplasia After Endoluminal Ablation: a Ticking Time Bomb or Much Ado About Nothing?

Excerpt

Barrett’s esophagus (BE) is defined as a condition of intestinal metaplasia of the esophagus that replaces normal squamous epithelium with columnar epithelium including goblet cells. BE is associated with an increase risk for the development esophageal adenocarcinoma (EAC). The incidence of EAC has increased by more than fivefold since 1970. Most patients with BE have non-dysplastic intestinal metaplasia. However, with continued and uncontrolled inflammation from gastroesophageal reflux disease, BE can progress to more abnormal histologic features ranging from low-grade to high-grade dysplasia. Although the incidence of developing dysplasia from non-dysplastic BE remains less than 2 %, patients with high-grade dysplasia have an EAC risk of more than 10 % per patient-year. Until recently, esophagectomy has been employed as the standard treatment option in patients with high-grade dysplasia. …