Laparoscopic transgastric esophageal mucosal resection: a treatment option for patients with high-grade dysplasia in Barrett's esophagus

Am J Surg. 2016 Mar;211(3):534-6. doi: 10.1016/j.amjsurg.2015.12.008. Epub 2015 Dec 31.

Abstract

Background: We present long-term follow-up data on patients with esophageal high-grade dysplasia and/or carcinoma in situ who were treated with laparoscopic transgastric esophageal mucosal resection (LTEMR).

Methods: Patient demographics, operative outcomes, and follow-up results were tabulated.

Results: LTEMR was performed in 11 patients (9 male, 2 female). The median age was 54 (44 to 75) years. The 30-day morbidity or mortality was zero. The median follow-up was 5.2 (2 to 12) years. Upper endoscopy was performed at 3, 6, and 12 month, and yearly thereafter. All patients regenerated squamous epithelium at 6 months. One patient developed a recurrence of Barrett's epithelium 2 years after resection. No recurrences of high-grade dysplasia or carcinoma were observed in any of the patients. Two patients developed an esophageal stricture; both were treated successfully with endoscopic balloon dilation and have suffered no further sequelae.

Conclusions: LTEMR is safe and effective alternative method to treat patients with Barrett's esophagus with high-grade dysplasia.

Keywords: Barrett's esophagus; Endoscopic resection; High-grade dysplasia; Mucosal resection.

MeSH terms

  • Adult
  • Aged
  • Barrett Esophagus / pathology
  • Barrett Esophagus / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Precancerous Conditions / pathology
  • Precancerous Conditions / surgery*
  • Treatment Outcome