Watson Thomas J
Division of Thoracic and Esophageal Surgery, Department of Surgery, MedStar Washington, Georgetown University School of Medicine, 3800 Reservoir Road Northwest, 4PHC, Washington, DC 20007, USA.
Gastrointest Endosc Clin N Am. 2017 Jul;27(3):531-546. doi: 10.1016/j.giec.2017.02.009. Epub 2017 Apr 22.
Endoscopic therapies have become the standard of care for most cases of Barrett's esophagus with high-grade dysplasia or intramucosal adenocarcinoma. Despite a rapid and dramatic evolution in treatment paradigms, esophagectomy continues to occupy a place in the therapeutic armamentarium for superficial esophageal neoplasia. The managing physician must remain cognizant of the limitations of endoscopic approaches and consider surgical resection when they are exceeded. Esophagectomy, performed at experienced centers for appropriately selected patients with early-stage disease can be undertaken with the expectation of cure as well as low mortality, acceptable morbidity, and good long-term quality of life.
内镜治疗已成为大多数伴有高级别异型增生或黏膜内腺癌的巴雷特食管病例的标准治疗方法。尽管治疗模式迅速且显著地演变，但食管切除术在浅表性食管肿瘤的治疗手段中仍占有一席之地。主治医生必须始终认识到内镜治疗方法的局限性，并在这些局限性超出范围时考虑手术切除。在经验丰富的中心，为适当选择的早期疾病患者进行食管切除术，有望实现治愈，同时死亡率低、发病率可接受且长期生活质量良好。
