Barrett's esophagus surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2] Amresh Kumar MD [3]
Overview
According to the American College of Gastroenterology, there are various surgical methods used for the treatment of Barrett's esophagus which includes antireflux surgery considered in those with incomplete control of reflux on optimized medical therapy, esophagectomy in cases of Endoscopic adenocarcinoma (EAC) with invasion into the submucosa and Nissen fundoplication used in the patient with GERD symptoms.
Surgery
According to the American College of Gastroenterology, indication for the surgery in Barrett's esophagus patients are:[1][2]
- Antireflux surgery should not be pursued in patients with BE as an antineoplastic measure. However, this surgery should be considered in those with incomplete control of reflux on optimized medical therapy.
- In cases of Endoscopic adenocarcinoma (EAC) with invasion into the submucosa, especially those with invasion to the mid or deep submucosa (T1b, sm2–3), esophagectomy, with consideration of neoadjuvant therapy, is recommended in the surgical candidate.
- In patients with T1a or T1b sm1 EAC, poor differentiation, lymphovascular invasion, or incomplete Endoscopic mucosal resection (EMR ) should prompt consideration of surgical and/or multimodality therapies.
Various surgical methods used for the treatment of Barrett's esophagus are:
- Esophagectomy
- Nissen fundoplication is used in the patient with GERD symptoms
References
- ↑ "Diagnosis and Management of Barrett's Esophagus | American College of Gastroenterology".
- ↑ Amano Y, Kinoshita Y (2008). "Barrett esophagus: perspectives on its diagnosis and management in asian populations". Gastroenterol Hepatol (N Y). 4 (1): 45–53. PMC 3394474. PMID 22798736.