Review Article
Hendrik Manner
Abstract
Endoscopic treatment of early esophageal neoplasia has widely been established in gastroenterology. It has been shown to be effective and safe also in the long-term follow-up, and it is – in contrast to the previous goldstandard, which is esophageal resection – organ preserving. There is no treatment-related mortality and a very low morbidity. In early Barrett’s neoplasia, the two-step concept of endoscopic resection (ER) of all neoplasia and thermal ablation of the non-neoplastic remainder of the Barrett’s segment is the treatment of choice, combining a high rate of curation with a low risk of treatment-related stricture formation. There are two ER techniques for early esophageal neoplasia: The suck-and-cut technique and endoscopic submucosal dissection, the latter one mainly used for squamous cell cancer. For thermal ablation, radiofrequency ablation (RFA) and argon-plasma coagulation (APC) are mainly used.