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A Mastery Approach to Complex Esophageal DiseasesBarrett Esophagus

A Mastery Approach to Complex Esophageal Diseases: Barrett Esophagus [Barrett esophagus is a change of the normal squamous epithelium of the esophagus to specialized columnar metaplasia. Barrett esophagus is only important in that is associated with an increased risk of development of adenocarcinoma. It has a prevalence of 1.6% of the general population and an incidence of 9.9/1000 patients/year. Gastroesophageal reflux, male gender, Caucasian race, and obesity are the primary risk factors and duodeno-gastro-esophageal reflux is the primary causative agent. The pathogenesis of Barrett esophagus has not been fully elucidated, but it is believed that acid and bile leads to a cascade of genomic, transcriptomic and epigenetic changes leading to the progression of normal squamous epithelium to metaplasia, dysplasia and finally carcinoma. Screening for Barrett esophagus is controversial and should only be considered for high-risk populations. Endoscopic radiofrequency ablation is the preferred treatment modality for high-grade dysplasia and should be considered for low-grade dysplasia. Esophagectomy should only be considered for persistent high-graded dysplasia or high suspicion of invasive carcinoma.] http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

A Mastery Approach to Complex Esophageal DiseasesBarrett Esophagus

Editors: Oleynikov, Dmitry; Fisichella, P. Marco
Velanovich, Vic
A Mastery Approach to Complex Esophageal Diseases — Apr 21, 2018
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Publisher
Springer International Publishing
Copyright
© Springer International Publishing AG, part of Springer Nature 2018
ISBN
978-3-319-75794-0
Pages
143 –155
DOI
10.1007/978-3-319-75795-7_11
Publisher site
See Chapter on Publisher Site

Abstract

[Barrett esophagus is a change of the normal squamous epithelium of the esophagus to specialized columnar metaplasia. Barrett esophagus is only important in that is associated with an increased risk of development of adenocarcinoma. It has a prevalence of 1.6% of the general population and an incidence of 9.9/1000 patients/year. Gastroesophageal reflux, male gender, Caucasian race, and obesity are the primary risk factors and duodeno-gastro-esophageal reflux is the primary causative agent. The pathogenesis of Barrett esophagus has not been fully elucidated, but it is believed that acid and bile leads to a cascade of genomic, transcriptomic and epigenetic changes leading to the progression of normal squamous epithelium to metaplasia, dysplasia and finally carcinoma. Screening for Barrett esophagus is controversial and should only be considered for high-risk populations. Endoscopic radiofrequency ablation is the preferred treatment modality for high-grade dysplasia and should be considered for low-grade dysplasia. Esophagectomy should only be considered for persistent high-graded dysplasia or high suspicion of invasive carcinoma.]

Published: Apr 21, 2018

Keywords: Barrett esophagus; Gastroesophageal reflux; Barrett prevention; Esophageal adenocarcinoma prevention; Endoscopic ablation; Esophagectomy

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