Journal List > Korean J Gastroenterol > v.74(1) > 1129956

Yoo and Joo: Diagnosis and Management of Barrett's Esophagus, Dysplasia and Early Esophageal Adenocarcinoma: Focusing on American and European Guidelines

Abstract

Barrett's esophagus (BE) is one of the most prominent diseases in Western countries because of its potential to progress to dysplasia or adenocarcinoma. Recently, the American College of Gastroenterology (ACG), American Gastroenterology Association (AGA), and European Society of Gastrointestinal Endoscopy (ESGE) developed clinical guidelines for the diagnosis and management of BE. All three guidelines commonly stressed the necessity of the endoscopic eradication of confirmed, nonnodular low grade dysplasia or high grade dysplasia, as well as the endoscopic elimination of the remaining BE after an endoscopic resection of visible mucosal abnormalities. An endoscopic resection is also considered for the optimal management of esophageal adenocarcinoma confined to the mucosa (T1a), and even in selective cases of submucosal invasion (T1b). As endoscopic therapy becomes the mainstay for the treatment of BE and its complications, the eligibility of pathologic or endoscopic experts and the BE expert center are being set and strengthened. This paper introduces the statements of the ACG, AGA and ESGE guidelines and compares the similarities and differences between them.

Figures and Tables

Table 1

Screening and Surveillance for Barrett's Esophagus

kjg-74-11-i001

ACG, American Colleague of Gastroenterology; GERD, gastroesophageal reflux disorder; BE, Barrett's esophagus; EAC, esophageal adenocarcinoma; GEJ, gastroesophageal junction; SCJ, squamous columnar junction; ESGE, European Society of Gastrointestinal Endoscopy; LA, Los Angeles.

Table 2

Diagnosis and Management of Low Grade Dysplasia of Barrett's Esophagus

kjg-74-11-i002

ACG, American Colleague of Gastroenterology; GI, gastrointestinal; LGD, low grade dysplasia; BE, Barrett's esophagus; AGA, American Gastroenterology Association; RFA, radiofrequency ablation; ESGE, European Society of Gastrointestinal Endoscopy.

Table 3

Diagnosis and Management of High Grade Dysplasia and Esophageal Adenocarcinoma of Barrett's Esophagus

kjg-74-11-i003

HGD, high grade dysplasia; EAC, esophageal adenocarcinoma; BE, Barrett's esophagus; EUS, endoscopic ultrasonography; ACG, American Colleague of Gastroenterology; EMR, endoscopic mucosal resection; ESGE, European Society of Gastrointestinal Endoscopy; SM, submucosal; RFA, radiofrequency ablation.

Notes

Financial support None.

Conflict of interest None.

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Moon Kyung Joo
https://orcid.org/0000-0001-6050-3695

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