Endoscopic ablation therapy for Barrett's esophagus with high-grade dysplasia: A review

Besides esophagectomy and antireflux therapy with intensive endoscopic surv eillance, endoscopic ablation therapy is a new treatment modality for Barre tt's esophagus (BE) with high-grade dysplasia (HGD). Endoscopic surgical ab lation can be performed by either a thermal, chemical, or mechanical method . This article describes the current management of patients with BE and HGD and the various methods of endoscopic ablation, including multipolar elect rocoagulation, argon plasma beam coagulation, contact laser photoablation, and photodynamic therapy. It also summarizes the results of 37 patient stud ies, case reports, and abstracts on experimental endoscopic therapies for B E. The advantages and disadvantages of the various treatment possibilities are considered, and the future direction of the management of BE is discuss ed. (C) 1999 by Am. Cell. of Gastroenterology.