Endoscopic Therapy for Early Esophageal Neoplasia

Endoscopic treatment of early esophageal neoplasia has widely been established in gastroenterology. It has been shown to be effective and safe also in the long-term follow-up, and it is – in contrast to the previous goldstandard, which is esophageal resection – organ preserving. There is no treatment-related mortality and a very low morbidity. In early Barrett’s neoplasia, the two-step concept of endoscopic resection (ER) of all neoplasia and thermal ablation of the non-neoplastic remainder of the Barrett’s segment is the treatment of choice, combining a high rate of curation with a low risk of treatment-related stricture formation. There are two ER techniques for early esophageal neoplasia: The suck-and-cut technique and endoscopic submucosal dissection, the latter one mainly used for squamous cell cancer. For thermal ablation, radiofrequency ablation (RFA) and argon-plasma coagulation (APC) are mainly used.