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Postgraduate Medical Journal 2007;83:367-372; doi:10.1136/pgmj.2006.054841
Copyright © 2007 The Fellowship of Postgraduate Medicine
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REVIEW

Endoscopic mucosal resection of Barrett’s oesophagus containing dysplasia or intramucosal cancer

S Seewald 1, T L Ang 2, N Soehendra 1

1 Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
2 Division of Gastroenterology, Changi General Hospital, Singapore

Correspondence to:
Correspondence to:
Dr Stefan Seewald
Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; seewald{at}uke.uni-hamburg.de

Barrett’s oesophagus is premalignant. Oesophagectomy is traditionally regarded as the standard treatment option in the presence of high grade intraepithelial neoplasia or intramucosal cancer. However, oesophagectomy is associated with high rates of mortality and morbidity. Endoscopic ablative therapies are limited by the lack of tissue for histological assessment, and the ablation may be incomplete. Endoscopic mucosal resection is an alternative to surgery in the management of high grade intraepithelial neoplasia and intramucosal cancer. It is less invasive than surgery and, unlike ablative treatments, provides tissue for histological assessment. This review will cover the indications, techniques and results of endoscopic mucosal resection.

Abbreviations: APC, argon plasma coagulation; EMR, endoscopic mucosal resection; EMRC, cap assistant endoscopic mucosal resection; EMRL, endoscopic mucosal resection with ligation; EST, endoscopic submucosal dissection; EUS, endoscopic ultrasound; GORD, gastro-oesophageal reflux disease; HGIN, high grade intraepithelial neoplasia; IMC, intramucosal cancer; LGIN, low grade intraepithelial neoplasia; PDT, photodynamic therapy






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