Barrett's esophagus surgery: Difference between revisions
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*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 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. | *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. | ||
==References== | ==References== | ||
Revision as of 18:55, 4 February 2018
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Barrett's Esophagus Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Barrett's esophagus surgery On the Web |
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American Roentgen Ray Society Images of Barrett's esophagus surgery |
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Risk calculators and risk factors for Barrett's esophagus surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Surgical intervention is not recommended for the management of [disease name].
OR
Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
OR
The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
OR
The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
OR
Surgery is the mainstay of treatment for [disease or malignancy].
Overview
Surgery
Surgical removal of most of the esophagus is recommended if a person with Barrett’s esophagus is found to have severe dysplasia or cancer and can tolerate a surgical procedure. Many people with Barrett’s esophagus are older and have other medical problems that make surgery unwise; in these people, the less invasive endoscopic treatments would be considered. Surgery soon after diagnosis of severe dysplasia or cancer may provide a person with the best chance for a cure. The type of surgery varies, but it usually involves removing most of the esophagus, pulling a portion of the stomach up into the chest, and attaching it to what remains of the esophagus.
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.
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.