Parquet Romina A, Sáenz Roque F
Latin American WGO and OMGE Gastrointestinal Endoscopy Advanced Training Center, Clínica Alemana-Olympus-Universidad del Desarrollo, Santiago de Chile. Chile.
Acta Gastroenterol Latinoam. 2007 Dec;37(4):250-8.
Actual Barrett's esophagus management includes symptomatic approach for GERD in order to prevent erosive injury and endoscopic & histologycal surveillance to detect dysplasia and early cancer. In high-grade dysplasia and superficial carcinoma, less aggressive procedures has been attempted to avoid extended surgery, such as Argon Plasma Coagulator, Multipolar Coagulation, Heater Probe, Photodynamic Therapy, and recently radiofrequency local treatment, associated or not to antireflux surgery. Ultrasonic therapy and Cryotherapy are new approaches, which are under clinical investigation. Barrett's epithelium resection utilizing endoscopical mucosal resection is a new promising procedure, which comes to the arena, allowing besides the compromised epithelium removal, its complete pathological evaluation and probably a curative intent. The actual revision intents to discuss the results of the different alternatives at the platform of treatment in dysplastic Barrett's or early carcinoma growing in the Barrett's epithelium.
巴雷特食管的实际管理包括针对胃食管反流病的对症治疗，以预防糜烂性损伤，以及进行内镜和组织学监测以检测发育异常和早期癌症。对于高级别发育异常和浅表癌，已尝试采用侵袭性较小的手术方法以避免进行扩大手术，如氩等离子凝固术、多极电凝术、热探头治疗、光动力疗法，以及最近的射频局部治疗，这些治疗可联合或不联合抗反流手术。超声治疗和冷冻疗法是正在进行临床研究的新方法。利用内镜黏膜切除术切除巴雷特上皮是一种新的有前景的手术方法，它进入了这个领域，除了能切除受损上皮外，还能对其进行完整的病理评估，并且可能具有治愈目的。本次综述旨在讨论在发育异常的巴雷特食管或生长于巴雷特上皮的早期癌的治疗平台上，不同治疗方法的结果。
