*EMBARGOED All research presented at the 2020 ACG Annual Scientific Meeting and Postgraduate Course is strictly embargoed until Monday, October 26, 2020, at 8:00 am EDT.

Saeed Ali, MD
Saeed Ali, MD

Oral 8 Efficacy and Safety of Endoscopic Submucosal Dissection and Endoscopic Mucosal Resection in Barrett’s Esophagus-Related Early Neoplasia: A Systematic Review and Pooled Comparative Analysis

Author Insight from Saeed Ali, MD, University of Iowa Hospitals and Clinics

What’s new here and important for clinicians?

  • f-EMR+RFA, s-EMR, and ESD are effective modalities for BE related HGD and EAC.
  • There was no difference in the recurrence of neoplasia with any endoscopic modality.
  • f-EMR+RFA was associated with a lower risk of perforation as compared to ESD and lower risk of stricture formation and bleeding as compared to s-EMR.

    What do patients need to know?

  • Barrett’s esophagus (BE) is a pre-malignant condition. Annual risk of esophageal adenocarcinoma (EAC) is 0.25% in patients without dysplasia, and 6% in patients with high-grade dysplasia (HGD).
  • Patients need to follow their gastroenterologist’s recommendation for screening and surveillance of Barrett’s esophagus related dysplasia and cancer following ACG guidelines.
  • Focal endoscopic mucosal resection followed by radiofrequency ablation (f-EMR+RFA), step-wise EMR (s-EMR), and endoscopic submucosal dissection (ESD) are the three endoscopic modalities that have been used for the management of BE related neoplasia.
  • Although there was no difference in risk of recurrence of BE associated neoplasia in this indirect comparative analysis, we found f-EMR+RFA to be associated with a lower risk of perforation as compared to ESD and it was also associated with a lower risk of stricture formation and bleeding as compared to s-EMR.

    • Read the Abstract

    Author Contact
    Saeed Ali, MD, University of Iowa Hospitals and Clinics
    saeed-ali [at] uiowa [dot] edu

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