Barrett's Esophagus: Treatment Options

In the past few years, treatment for Barrett's esophagus has entered an important era with the development of a number of effective treatments to eradicate metaplastic mucosa, dysplasia, and early esophageal cancer. These endoscopic treatment options can be divided into two distinct categories: (1) tissue-acquiring methods such as endoscopic mucosal resection and endoscopic submucosal dissection, and (2) tissue ablation methods such as radiofrequency ablation, photodynamic therapy, argon plasma coagulation, cryoablation, multipolar electrocoagulation, and neodymium-doped yttrium aluminum garnet laser therapy. Currently endoscopic mucosal resection, radiofrequency ablation and photodynamic therapy are the mainstay of endoscopic therapies for Barrett's. Esophagectomy is predominantly indicated for patients with lesions that are more advanced than intramucosal cancer (more advanced than T1a), or those who have failed endoscopic management.