CIRCUMFERENTIAL ENDOSCOPIC SUBMUCOSAL DISSECTION FOR REFRACTORY DYSPLASTIC BARRETT’S ESOPHAGUS AFTER MUCOSAL RESECTIONS AND RADIOFREQUENCY ABLATION – A SALVAGE AND DEFINITIVE TREATMENT APPROACH?

77-year-old woman with C5M6 Barrett’s esophagus(BE) and progressive high grade dysplasia (HGD) visible lesions despite sequential endoscopic mucosal resection procedures and radiofrequency ablation of the remaining BE. The patient was referred to our department for endoscopic submucosal dissection (ESD). Regardless of extensive scaring and submucosal fibrosis from previous procedures, en-bloc circumferential excision of a 6cm-length segment encompassing all the dysplastic lesions was successfully achieved. Histological showed extensive HGD, completely resected.

ESD as salvage therapy for BE-related dysplasia or neoplasia is feasible for achieving en-bloc and R0 resection for larger or poorly lifting lesions because of scaring, with an acceptable safety profile.

Publication History

Article published online:
14 April 2022