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Past, present and future of Barrett's oesophagus

Published version
Peer-reviewed

Type

Article

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Authors

Tan, WK 
di Pietro, M 
Fitzgerald, Rebecca  ORCID logo  https://orcid.org/0000-0002-3434-3568

Abstract

Barrett's oesophagus is a condition which predisposes towards development of oesophageal adenocarcinoma, a highly lethal tumour which has been increasing in incidence in the Western world over the past three decades. There have been tremendous advances in the field of Barrett's oesophagus, not only in diagnostic modalities, but also in therapeutic strategies available to treat this premalignant disease. In this review, we discuss the past, present and future of Barrett's oesophagus. We describe the historical and new evolving diagnostic criteria of Barrett's oesophagus, while also comparing and contrasting the British Society of Gastroenterology guidelines, American College of Gastroenterology guidelines and International Benign Barrett's and CAncer Taskforce (BOBCAT) for Barrett's oesophagus. Advances in endoscopic modalities such as confocal and volumetric laser endomicroscopy, and a non-endoscopic sampling device, the Cytosponge, are described which could aid in identification of Barrett's oesophagus. With regards to therapy we review the evidence for the utility of endoscopic mucosal resection and radiofrequency ablation when coupled with better characterization of dysplasia. These endoscopic advances have transformed the management of Barrett's oesophagus from a primarily surgical disease into an endoscopically managed condition.

Description

Keywords

Barrett's oesophagus, diagnosis, management, guidelines, endoscopy, cytosponge

Journal Title

European Journal of Surgical Oncology

Conference Name

Journal ISSN

0748-7983
1532-2157

Volume Title

Publisher

Elsevier
Sponsorship
The BEST-1 study was funded by the Medical Research Council gap fund. The BEST-2 study was funded by Cancer Research UK.