Cholapranee Aurada, Trindade Arvind J
Division of Gastroenterology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Long Island Jewish Medical Center, 270-05 76th Avenue, New Hyde Park, NY, 11040, USA.
Curr Treat Options Gastroenterol. 2019 Mar;17(1):32-47. doi: 10.1007/s11938-019-00215-8.
Barrett's esophagus (BE) is the only known measurable factor associated with esophageal adenocarcinoma. The development of endoscopic eradication therapy (EET) has transformed the way BE is managed. Given the fairly recent development of EET, its role in BE is still evolving.
This paper discusses the challenges that endoscopists face at the preprocedural, intraprocedural, and postprocedural stages of BE management. These include challenges in risk stratification, dysplasia detection, ablation methods and dosimetry, choice of resection technique, and management of refractory disease. Despite the advances in EET in BE, there remain challenges that this review focuses on. Future research into these challenges will optimize ablation techniques and strategies in the future.
巴雷特食管(BE)是已知的与食管腺癌相关的唯一可测量因素。内镜根除治疗(EET)的发展改变了BE的管理方式。鉴于EET是最近才发展起来的,其在BE中的作用仍在不断演变。
本文讨论了内镜医师在BE管理的术前、术中和术后阶段面临的挑战。这些挑战包括风险分层、发育异常检测、消融方法和剂量测定、切除技术的选择以及难治性疾病的管理。尽管EET在BE治疗方面取得了进展,但本综述仍关注一些挑战。对这些挑战的未来研究将优化未来的消融技术和策略。