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CC BY 4.0 · Journal of Digestive Endoscopy 2024; 15(04): 250-253
DOI: 10.1055/s-0044-1791953
Endoscopy Video

Circumferential Endoscopic Submucosal Dissection for Barrett's Esophagus with Multifocal High-Grade Dysplasia

Pankaj Gupta
1   Institute of Liver and Gastrointestinal Sciences, Max Super Speciality Hospital, New Delhi, India
,
Vikas Singla 
1   Institute of Liver and Gastrointestinal Sciences, Max Super Speciality Hospital, New Delhi, India
,
Pankaj Singh
1   Institute of Liver and Gastrointestinal Sciences, Max Super Speciality Hospital, New Delhi, India
,
Kalpana Acharya 
1   Institute of Liver and Gastrointestinal Sciences, Max Super Speciality Hospital, New Delhi, India
,
Komal Aggarwal
2   Department of Pathology, Max Super Speciality Hospital, New Delhi, India
,
Harish Soni 
1   Institute of Liver and Gastrointestinal Sciences, Max Super Speciality Hospital, New Delhi, India
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Abstract

A 54-year-old male presented with longstanding history of heartburn and regurgitation. Upper gastrointestinal endoscopy and biopsy performed at the previous center were suggestive of Barrett's esophagus with high-grade dysplasia (HGD). In view of dysplasia with underlying Barrett's esophagus, endoscopic submucosal dissection (ESD) was planned. Multifocal high-grade dysplasia with underlying Barrett's esophagus needs treatment to prevent invasive cancer. Surgery has been the conventional treatment but is associated with morbid complications and mortality. ESD has emerged as a treatment for HGD and superficial adenocarcinoma in Barrett's segment, but circumferential ESD is associated with risk of stricture formation. The present case highlights the role of image-enhanced endoscopy in identifying dysplasia in Barrett's esophagus and minimally invasive endoscopic techniques as an alternative to conventional surgical techniques and prophylactic measures needed to prevent post-ESD complications.

Keywords

Barrett's esophagus - ESD - NBI - stricture after ESD


Publication History

Article published online:
26 December 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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