High-grade dysplasia in Barrett's esophagus: The case for esophagectomy
Section snippets
WHY MUST HIGH-GRADE DYSPLASIA BE RESECTED?
Arising in intestinal metaplasia of the esophagus, HGD is a malignant condition that is limited to the epithelium of the mucosal layer. Indeed, HGD, also termed carcinoma in situ, consists of unequivocal neoplastic abnormalities in the mucosal architecture and the cellular morphology of full thickness of the epithelium without any invasion of the lamina propria beyond the basement membrane. So, nuclei of the epithelial cells are enlarged, hyperchromatic, irregular, and polymitotic.35, 64 From a
References (84)
- et al.
High-grade dysplasia in the columnar-lined esophagus
Am J Surg
(1991) - et al.
Motor activity after colon replacement of esophagus
J Thorac Cardiovasc Surg
(1981) - et al.
Radical esophageal resection for adenocarcinoma arising in Barrett'sesophagus
Am J Surg
(1997) - et al.
Esophageal replacement: Gastric tube or whole stomach?
Ann Thorac Surg
(1995) - et al.
Terminalized semimechanical side-to-side suture technique for cervicalesophagogastrostomy
Ann Thorac Surg
(1998) - et al.
Roux-en-Y jejunal loop and bile reflux
Am J Surg
(2000) - et al.
Barrett's esophagus and adenocarcinoma of the esophagus and gastroesophagealjunction
J Thorac Cardiovasc Surg
(1991) - et al.
Endoscopic mucosal resection of early cancer and high-grade dysplasia inBarrett's esophagus
Gastroenterology
(2000) - et al.
Jumbo biopsy forceps protocol still misses unsuspected cancer in Barrett'sesophagus with high-grade dysplasia
Gastrointest Endosc
(1999) - et al.
Endosonography in the evaluation of patients with Barrett's esophagus andhigh-grade dysplasia
Gastrointest Endosc
(1994)
Resection for Barrett's mucosa with high-grade dysplasia: Implications forprophylactic photodynamic therapy
J Thorac Cardiovasc Surg
Bile exposure of the denervated stomach as an esophageal substitute
Ann Thorac Surg
Barrett's esophagus: Development of dysplasia and adenocarcinoma
Gastroenterology
Regeneration of cardiac type mucosa and acquisition of Barrett mucosa afteresophagogastrostomy
Gastroenterology
An endoscopic biopsy protocol can differentiate high-grade dysplasia fromearly adenocarcinoma in Barrett's esophagus
Gastroenterology
Distribution of dysplasia and early invasive carcinoma in Barrett's esophagus
Hum Pathol
Barrett's esophagus: Does an antireflux procedure reduce the need forendoscopic surveillance?
J Thorac Cardiovasc Surg
Minimally invasive esophagectomy for Barrett's esophagus with high-gradedysplasia
Surgery
Photodynamic therapy for Barrett's esophagus: Follow-up in 100 patients
Gastrointest Endosc
Barrett's esophagus with high-grade dysplasia: An indication foresophagectomy?
Ann Thorac Surg
Outcome of adenocarcinoma arising in Barrett's esophagus in endoscopicallysurveyed and nonsurveyed patients
J Thorac Cardiovasc Surg
Endoscopic biopsy can detect high-grade dysplasia or early adenocarcinoma inBarrett's esophagus without grossly recognizable neoplastic lesions
Gastroenterology
Observer variation in the diagnosis of dysplasia in Barrett's esophagus
Hum Pathol
Endoscopic surveillance of Barrett's esophagus: Does it help?
J Thorac Cardiovasc Surg
Esophageal stripping with preservation of the vagus nerve
Int Surg
Impact of hospital volume on operative mortality for major cancer surgery
JAMA
Reconstruction of the esophagus with left colon
J Thorac Cardiovasc Surg
Rising incidence of adenocarcinoma of the esophagus and gastric cardia
JAMA
Barrett's esophagus, high-grade dysplasia, and early adenocarcinoma: Apathological study
Am J Gastroenterol
Complications of Barrett's esophagus: Indications for esophageal resectionwith special reference to high-grade dysplasia
Minerva Chir
A single centre's 20 years' experience of columnar-lined (Barrett's)oesophagus diagnosis
Eur J Gastroenterol Hepatol
Peptic stenosis: What are the residual indications of esophagectomy inreference to the other therapies?
Exclusive radical surgery for esophageal adenocarcinoma
Cancer
Skeletonizing en-bloc esophagectomy for cancer
Ann Surg
An original technique for lengthening the stomach as an oesophagealsubstitute after esophagectomy
The denervated stomach as an esophageal substitute is a contractile organ
Ann Surg
Human stomach has a recordable mechanical activity at a rate of about threecycles/minute
Eur J Surg
Erythromycin enhances early postoperative contractility of the denervatedwhole stomach as an esophageal substitute
Ann Surg
Indications, surgical techniques, and long-term functional results of coloninterposition
Ann Surg
Barrett esophagus in the esophageal stump after subtotal esophagectomy withcervical esophago-gastroplasty
Rev Hosp Clin Fac Med Sao Paulo
The rationale for esophagectomy as the optimal therapy for Barrett'sesophagus with high-grade dysplasia
Ann Surg
Cited by (79)
Personalizing Therapy for Esophageal Cancer Patients
2013, Thoracic Surgery ClinicsCitation Excerpt :High-grade dysplasia (HGD) has the highest risk of progression to adenocarcinoma, although the natural history of HGD remains unclear. Based on previous studies demonstrating that concomitant cancer was found in approximately 40% of surgically resected specimens of patients who had a preoperative diagnosis of only HGD,5,6 surgical resection of the esophagus (esophagectomy) has been recommended as standard of care. Esophagectomy is one of the most complex procedures used in the gastrointestinal tract, and its mortality rate may exceed 3%.7,8
Esophageal Preservation in Esophageal High-Grade Dysplasia and Intramucosal Adenocarcinoma
2011, Thoracic Surgery ClinicsAmerican gastroenterological association technical review on the management of Barrett's esophagus
2011, GastroenterologyCitation Excerpt :Endoscopists traditionally have used a 4-quadrant biopsy sampling system (which is essentially a random sampling technique) to find dysplasia in Barrett's esophagus, and it is clear that this system can miss areas of dysplasia and even cancer. In series of patients who underwent esophagectomies because endoscopic examination revealed high-grade dysplasia in Barrett's esophagus, for example, a number of studies have found that invasive cancer is present in 30% to 40% of the resected esophagi.87 However, a recent critical review of those studies suggests that 13% is a more accurate estimate of the frequency of invasive cancer in this situation, and when a careful endoscopic examination excludes all visible lesions, the frequency of finding invasive cancer at esophagectomy is only 3%.88
The role of surgery in the management of Barrett's esophagus (from dysplasia to cancer)
2011, Journal de Chirurgie VisceraleBarrett’s Esophagus
2010, Sleisenger and Fordtran’s Gastrointestinal and Liver Disease- 2 Volume Set: Pathophysiology, Diagnosis, Management, Expert Consult Premium Edition - Enhanced Online Features and PrintBarrett's esophagus with high-grade dysplasia: Focus on current treatment options
2011, World Journal of Gastroenterology