Low-grade dysplasia in Barrett’s esophagus - an innocent bystander? Contra

According to recent guidelines, the diagnosis of low-grade intraepithelial neoplasia (formerly known as ”low-grade dysplasia”, abbreviated to ”LGD”) in Barrett’s esophagus requires a more frequent surveillance program, examining patients until the histology is negative for neoplasia or until a higher degree of neoplasia is detected [1] [2]. This is rather difficult to understand because the guidelines for managing this condition in the colon, duodenum, and stomach advise gastroenterologists to remove foci of low-grade intraepithelial neoplasia (i. e. adenomas) completely rather than to wait for the lesion to disappear or progress (which would be regarded as a rather lazy, or at least an unethical attitude with respect to such lesions in these sites).

References

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