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

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

Publikationsverlauf

Artikel online veröffentlicht:
26. Dezember 2024

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