Over the past years, endoscopic treatment has gradually replaced surgery as the first management strategy for early neoplasia in Barrett’s oesophagus.
Endoscopic treatment as a less invasive alternative to surgery has shown impressive success rates both for removal of neoplasia and for complete endoscopic and histological removal of all Barrett’s mucosa.
Endoscopic resection (ER) is the cornerstone of endoscopic treatment, as it allows for removal of visible lesions and renders the mucosa flat for subsequent ablation therapy. “Endoscopic resection (ER-cap, MBM, ESD)” discusses when to perform ER, and which technique to use.
Ablation of residual Barrett’s is generally recommended after ER for early neoplasia. The basic principles of RFA are discussed in the “Technical aspects of BARRX360 and BARRX90”. Whether RFA should also be performed in patients with low-grade dysplasia or non-dysplastic Barrett’s oesophagus, is discussed in “RFA for non-dysplastic Barrett’s and LGD”.
Advanced endoscopists can find information and tips-and-tricks on how to treat challenging cases in “Pitfalls in endoscopic treatment” and “Challenging cases”.
