Bare fiber photodynamic therapy using porfimer sodium for esophageal disease

Endoscopic approaches to Barrett's oesophagus with high-grade dysplasia/early mucosal cancer

This chapter will review the endoscopic approaches to the management of Barrett's oesophagus with high-grade dysplasia/early mucosal cancer. Factors to consider when evaluating patients for endoscopic management are detailed. Ablation and resection methods for eradication of Barrett's oesophagus with high-grade dysplasia/early mucosal cancer are reviewed. Strategies for combining therapies to achieve safe and effective eradication are discussed. Recommendations for complete eradication of all Barrett's mucosa and follow-up considerations are put forward.

Endoluminal therapy for Barrett's esophagus

This article reviews methods to minimize the complications associated with endoscopic therapy for patients with Barrett's esophagus. To place this discussion in context, the natural history of Barrett's esophagus and the risks associated with progression to dysplasia and invasive carcinoma are reviewed. Operative esophageal resection traditionally is recommended for patients with Barrett's high-grade dysplasia and early carcinoma, and these surgical risks also are reviewed. Finally, all currently approved and commercially available methods for endoscopic ablation and resection of Barrett's disease are categorized according to their application methods of ablation: focal ablation, field ablation, and mucosal resection. The clinical experience with these devices is reviewed with their associated adverse events and complications. Caveats, concerns, and recommendations are discussed to help minimize the complications associated with the use of these important technologies that hold the promise of removing or destroying Barrett's disease to prevent the development of invasive carcinoma.