The rationale for esophagectomy as the optimal therapy for Barrett's esophagus with high-grade dysplasia.

摘要: Objective The authors determined the incidence of invasive adenocarcinoma after esophagectomy in patients endoscopically diagnosed as having Barrett's esophagus with high-grade dysplasia. Summary Background Data is a well-recognized premalignant condition. There controversy regard to optimal treatment dysplasia esophagus. Recognizing morbidity and mortality associated esophagectomy, some recommend selective approach, reserving only for evidence cancer identified through endoscopic surveillance. Others advocate all suitable operative candidates. Methods reviewed their experience between 1985 1995 11 arising by biopsy treated esophagectomy. Results All were white men ranging age from 47 70 years. Ten underwent Ivor Lewis technique ; one had transhiatal resection. Eight (73%) two (18%) positive lymph nodes required prolonged hospital stay an anastomotic leak temporarily suffered delayed gastric emptying. authors' review 85 additional previously reported during same period. Including current series, 39 (41%) resected specimen. A preponderance early, potentially curable carcinomas are characteristically found these patients. Conclusion high undetected carcinoma strongly supports preferred approach candidates