Barrett's esophagus, towards improved clinical practice

Abstract

The main clinical relevance of Barrett's esophagus (BE), a result of chronic exposure to gastroesophageal reflux, is its potential progression to esophageal adenocarcinoma (EAC). Although screening for BE is not recommended in the general population, after diagnosis of BE, a surveillance strategy for early detection of dysplasia or neoplasia is needed. The gold standard for diagnosis and surveillance is high-definition oral endoscopy with random biopsies. In addition, any visible lesion should be completely resected, which will be considered curative in the presence of low grade dysplasia (LGD), high-grade dysplasia (HGD) or EAC confined to the mucosa (T1a), followed by eradication of residual BE by endoscopic ablation. In the absence of a visible lesion, radiofrequency ablation should be performed to eradicate BE with LGD, HGD or intramucosal EAC.

Keywords: Ablación endoscópica; Adenocarcinoma de esófago; Barrett's esophagus; Diagnosis; Diagnóstico; Endoscopic ablation; Endoscopic resection; Esophageal adenocarcinoma; Esófago de Barrett; Resección endoscópica; Seguimiento; Surveillance.