BOOK
New Directions in Barrett's Esophagus, An Issue of Gastrointestinal Endoscopy Clinics E-Book
(2017)
Additional Information
Book Details
Abstract
Dr. Shaheen's issue of Gastrointestinal Endoscopy Clinics of North America addresses the current thinking and clinical decision making surrounding endoscopy for Barrett's Esophagus. Expert authors have contributed articles on the following topics: The Troublesome Epidemiology of Barrett’s Esophagus and Esophageal Adenocarcinoma; Who Deserves Endoscopic Screening for Esophageal Neoplasia; Alternatives to Traditional per oral Endoscopy for Screening; Effectiveness and Cost-Effectiveness of Endoscopic Screening and Surveillance; The Role of Adjunct Imaging in Endoscopic Detection of Dysplasia; Beyond Dysplasia Grade: The Role of Biomarkers in Stratifying Risk; Management of Nodular Neoplasia in Barrett’s Esophagus: Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection; EUS and Management of Superficial Esophageal Neoplasia; Radiofrequency Ablation of Barrett’s Esophagus: Patient Selection, Preparation, and Performance; Radiofrequency Ablation of Barrett’s Esophagus: Efficacy, Complications, and Durability; Cryotherapy of Barrett’s Esophagus; Care of the Post-Ablation Patient: Surveillance, Acid Suppression and Treatment of Recurrence; and Surgical Management of Superficial Esophageal Neoplasia. Readers will come away with the knowledge to diagnose and treat neoplasia and Barrett's Esophagus using the latest techniques.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| New Directions in Barrett’s Esophagus\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Foreword: Barrett’s Esophagus and the Prevention of Esophageal Adenocarcinoma | vii | ||
| Preface: New Directions in Barrett’s Esophagus | vii | ||
| The Troublesome Epidemiology of Barrett’s Esophagus and Esophageal Adenocarcinoma | vii | ||
| Who Deserves Endoscopic Screening for Esophageal Neoplasia? | vii | ||
| Alternatives to Traditional Per-Oral Endoscopy for Screening | vii | ||
| Effectiveness and Cost-Effectiveness of Endoscopic Screening and Surveillance | viii | ||
| The Role of Adjunct Imaging in Endoscopic Detection of Dysplasia in Barrett’s Esophagus | viii | ||
| Beyond Dysplasia Grade: The Role of Biomarkers in Stratifying Risk | viii | ||
| Management of Nodular Neoplasia in Barrett’s Esophagus: Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection | viii | ||
| The Role of Endoscopic Ultrasound in the Management of Patients with Barrett's Esophagus and Superficial Neoplasia | ix | ||
| Radiofrequency Ablation of Barrett’s Esophagus: Patient Selection, Preparation, and Performance | ix | ||
| Radiofrequency Ablation of Barrett’s Esophagus: Efficacy, Complications, and Durability | ix | ||
| Cryotherapy for Barrett’s Esophagus | ix | ||
| Care of the Postablation Patient: Surveillance, Acid Suppression, and Treatment of Recurrence | x | ||
| Esophagectomy for Superficial Esophageal Neoplasia | x | ||
| GASTROINTESTINAL ENDOSCOPY CLINICS\rOF NORTH AMERICA\r | xi | ||
| FORTHCOMING ISSUES | xi | ||
| October 2017 | xi | ||
| January 2018 | xi | ||
| April 2018 | xi | ||
| RECENT ISSUES | xi | ||
| April 2017 | xi | ||
| January 2017 | xi | ||
| October 2016 | xi | ||
| Foreword: Barrett’s Esophagus and the Prevention of Esophageal Adenocarcinoma\r | xiii | ||
| Preface:\rNew Directions in Barrett’s Esophagus | xv | ||
| The Troublesome Epidemiology of Barrett’s Esophagus and Esophageal Adenocarcinoma | 353 | ||
| Key points | 353 | ||
| DISEASE DESCRIPTION | 353 | ||
| NATIONAL AND GLOBAL INCIDENCE OF ESOPHAGEAL ADENOCARCINOMA | 354 | ||
| RISK FACTORS OVERVIEW | 355 | ||
| Demographic Factors (Nonmodifiable Risk Factors: Race, Gender, and Geography) | 355 | ||
| Obesity and Body Composition | 357 | ||
| Smoking | 359 | ||
| Gastroesophageal Reflux Disease | 359 | ||
| Helicobacter pylori | 359 | ||
| DISCUSSION: MAKING SENSE OF THE RISK FACTORS FOR BARRETT’S AND CANCER | 360 | ||
| REFERENCES | 362 | ||
| Who Deserves Endoscopic Screening for Esophageal Neoplasia? | 365 | ||
| Key points | 365 | ||
| INTRODUCTION | 365 | ||
| ACCURATELY DIAGNOSING THE PRECURSOR LESION | 366 | ||
| BARRETT’S ESOPHAGUS SCREENING: RATIONALE AND CHALLENGES | 367 | ||
| RISK FACTORS FOR BARRETT’S ESOPHAGUS | 369 | ||
| RISK SCORES | 372 | ||
| SUMMARY | 373 | ||
| REFERENCES | 373 | ||
| Alternatives to Traditional Per-Oral Endoscopy for Screening | 379 | ||
| Key points | 379 | ||
| INTRODUCTION | 379 | ||
| RATIONALE FOR SCREENING | 380 | ||
| CURRENT GUIDELINES FOR DIAGNOSIS OF BARRETT’S ESOPHAGUS | 380 | ||
| EVALUATING NOVEL SCREENING TEST | 383 | ||
| NOVEL SCREENING METHODS | 383 | ||
| Endoscopic Screening | 383 | ||
| Transnasal endoscopy | 383 | ||
| Video capsule endoscopy | 388 | ||
| Volumetric laser endomicroscopy | 389 | ||
| Nonendoscopic Screening | 389 | ||
| Cell collection devices | 389 | ||
| Circulating molecular markers | 391 | ||
| SUMMARY | 392 | ||
| ACKNOWLEDGMENTS | 392 | ||
| REFERENCES | 392 | ||
| Effectiveness and Cost-Effectiveness of Endoscopic Screening and Surveillance | 397 | ||
| Key points | 397 | ||
| INTRODUCTION | 397 | ||
| THE EFFECTIVENESS OF ENDOSCOPIC SCREENING AND SURVEILLANCE TO REDUCE MORTALITY FROM ESOPHAGEAL ADENOCARCINOMA | 398 | ||
| STUDIES OF THE EFFECTIVENESS OF ENDOSCOPIC SCREENING OR SURVEILLANCE | 399 | ||
| COST-EFFECTIVENESS OF SCREENING AND SURVEILLANCE | 402 | ||
| COST-EFFECTIVENESS ANALYSIS: DEFINITIONS | 402 | ||
| Costs | 402 | ||
| Incremental Cost-Effectiveness Ratio | 403 | ||
| Discounting | 403 | ||
| Utilities | 403 | ||
| Sensitivity Analysis | 403 | ||
| STUDIES OF THE COST-EFFECTIVENESS OF SCREENING AND SURVEILLANCE TO REDUCE MORTALITY FROM ESOPHAGEAL ADENOCARCINOMA | 404 | ||
| ENDOSCOPIC SCREENING BEFORE THE AVAILABILITY OF ENDOSCOPIC RADIOFREQUENCY ABLATION | 404 | ||
| ENDOSCOPIC SURVEILLANCE BEFORE THE AVAILABILITY OF ENDOSCOPIC RADIOFREQUENCY ABLATION | 404 | ||
| OTHER SCREENING MODALITIES | 407 | ||
| Ultrathin Endoscopy | 407 | ||
| Esophageal Capsule Endoscopy | 409 | ||
| Markers of Cancer | 409 | ||
| ENDOSCOPIC ABLATION FOR HIGH-GRADE DYSPLASIA | 410 | ||
| Photodynamic Therapy | 410 | ||
| Radiofrequency Ablation | 410 | ||
| MANAGEMENT OF NONDYSPLASTIC BARRETT’S ESOPHAGUS AND LOW-GRADE DYSPLASIA | 410 | ||
| Surveillance | 410 | ||
| Endoscopic Ablation of Low-Grade Dysplasia | 415 | ||
| Endoscopic Ablation of Nondysplastic Barrett’s Esophagus | 415 | ||
| CHEMOPREVENTION | 416 | ||
| SUMMARY | 416 | ||
| REFERENCES | 416 | ||
| The Role of Adjunct Imaging in Endoscopic Detection of Dysplasia in Barrett’s Esophagus | 423 | ||
| Key points | 423 | ||
| BACKGROUND | 423 | ||
| OPTICAL CHROMOENDOSCOPY: NARROW-BAND IMAGING | 425 | ||
| OPTICAL COHERENCE TOMOGRAPHY | 429 | ||
| VOLUMETRIC LASER ENDOMICROSCOPY | 429 | ||
| CONFOCAL LASER ENDOMICROSCOPY | 435 | ||
| AUTOFLUORESCENCE IMAGING | 436 | ||
| LABELED BIOMARKER ENDOSCOPY (MOLECULAR IMAGING) | 440 | ||
| SUMMARY | 441 | ||
| REFERENCES | 441 | ||
| Beyond Dysplasia Grade | 447 | ||
| Key points | 447 | ||
| INTRODUCTION | 447 | ||
| LIMITATIONS WITH USING DYSPLASIA TO STRATIFY CANCER RISK IN BARRETT’S ESOPHAGUS | 448 | ||
| BIOMARKER DEVELOPMENT: CANCER HALLMARKS | 449 | ||
| BIOMARKER DEVELOPMENT FOR BARRETT’S ESOPHAGUS IN THE PRECISION MEDICINE ERA | 450 | ||
| USE OF BIOMARKER PANELS TO ASSESS CANCER RISK IN BARRETT’S ESOPHAGUS | 452 | ||
| Methylation Arrays | 452 | ||
| Mutational Load | 453 | ||
| Histopathologic Biomarker Classification System | 453 | ||
| P53 IMMUNOSTAINING: SO CLOSE AND PERHAPS NOT SO FAR AWAY | 453 | ||
| CHALLENGES OF ENDOSCOPIC BARRETT’S ESOPHAGUS SURVEILLANCE AND NEW ADVANCES IN IMAGING | 454 | ||
| IN VIVO ENDOSCOPIC MOLECULAR IMAGING USING BIOMARKERS | 455 | ||
| Lectins | 455 | ||
| Peptides | 455 | ||
| Antibodies | 457 | ||
| SUMMARY | 457 | ||
| REFERENCES | 457 | ||
| Management of Nodular Neoplasia in Barrett’s Esophagus | 461 | ||
| Key points | 461 | ||
| INTRODUCTION | 461 | ||
| INDICATIONS FOR ENDOSCOPIC RESECTION | 462 | ||
| Mucosal Cancer | 462 | ||
| Submucosal Cancer | 462 | ||
| ENDOSCOPIC WORKUP | 463 | ||
| Detection of Early Neoplastic Lesions | 463 | ||
| Macroscopic Appearance of Early Barrett’s Neoplasia | 463 | ||
| PRINCIPLES OF ENDOSCOPIC RESECTION | 464 | ||
| En-bloc Resection Versus Piecemeal Endoscopic Resection | 464 | ||
| Marking the Target Lesion | 464 | ||
| ENDOSCOPIC RESECTION TECHNIQUES | 464 | ||
| Lift-Suck-Cut Technique | 464 | ||
| Ligate-and-Cut Technique | 465 | ||
| Endoscopic Submucosal Dissection | 466 | ||
| HISTOPATHOLOGICAL ASSESSMENT ENDOSCOPIC RESECTION SPECIMENS | 467 | ||
| ENDOSCOPIC TREATMENT ALGORITHM | 468 | ||
| REFERENCES | 468 | ||
| The Role of Endoscopic Ultrasound in the Management of Patients with Barrett's Esophagus and Superficial Neoplasia | 471 | ||
| Key points | 471 | ||
| INTRODUCTION | 471 | ||
| MANAGEMENT GOALS | 472 | ||
| Definition of Advanced Disease | 473 | ||
| Test Characteristics | 474 | ||
| EVALUATION | 474 | ||
| Safety of Esophageal Ultrasound | 474 | ||
| Availability of Esophageal Ultrasound | 475 | ||
| Cost-Effectiveness of Esophageal Ultrasound in Barrett Esophagus | 475 | ||
| Accuracy of Esophageal Ultrasound in Barrett Esophagus | 475 | ||
| DISCUSSION | 476 | ||
| SUMMARY | 477 | ||
| REFERENCES | 478 | ||
| Radiofrequency Ablation of Barrett’s Esophagus | 481 | ||
| Key points | 481 | ||
| INTRODUCTION | 481 | ||
| Patient Selection | 482 | ||
| Indications and contraindications for radiofrequency ablation | 482 | ||
| Discussion of Risks and Benefits with Patients | 483 | ||
| PREPARATION | 483 | ||
| PERFORMANCE | 485 | ||
| Circumferential Radiofrequency Ablation | 485 | ||
| Endoscopic inspection | 486 | ||
| Sizing balloon | 486 | ||
| First ablation | 486 | ||
| Removal of debris | 487 | ||
| Second ablation | 487 | ||
| Focal Radiofrequency Ablation | 487 | ||
| Endoscopic inspection | 487 | ||
| Choice of catheter | 488 | ||
| First ablation | 488 | ||
| Removal of debris | 488 | ||
| Second ablation | 488 | ||
| Three-hit, no clean alternative | 488 | ||
| Channel radiofrequency ablation device | 488 | ||
| POSTTREATMENT CARE | 488 | ||
| SUMMARY | 489 | ||
| REFERENCES | 489 | ||
| Radiofrequency Ablation of Barrett’s Esophagus | 491 | ||
| Key points | 491 | ||
| INTRODUCTION | 491 | ||
| EFFICACY | 492 | ||
| Initial Clinical Trials | 492 | ||
| Large Registries and Meta-analyses | 493 | ||
| Predictors of Response | 494 | ||
| COMPLICATIONS | 494 | ||
| Stricture | 494 | ||
| Safety of Endoscopic Mucosal Resection with Radiofrequency Ablation | 495 | ||
| Chest Discomfort | 495 | ||
| DURABILITY | 495 | ||
| Initial Clinical Trials | 496 | ||
| Large Registries and Meta-analyses | 496 | ||
| Predictors of Recurrence | 496 | ||
| Location of Recurrence | 496 | ||
| Implications for Management and Cancer Risk | 496 | ||
| Subsquamous Intestinal Metaplasia | 498 | ||
| SUMMARY | 499 | ||
| REFERENCES | 499 | ||
| Cryotherapy for Barrett’s Esophagus | 503 | ||
| Key points | 503 | ||
| BACKGROUND | 503 | ||
| ENDOSCOPIC CRYOTHERAPY SYSTEMS: TECHNICAL AND PROCEDURAL ISSUES | 504 | ||
| Cryoballoon Ablation | 506 | ||
| EFFICACY FOR ERADICATION OF DYSPLASIA AND INTESTINAL METAPLASIA | 508 | ||
| SAFETY OF CRYOTHERAPY | 509 | ||
| Liquid Nitrogen CryoSpray | 509 | ||
| Carbon Dioxide Cryotherapy | 510 | ||
| Cryoballoon Ablation | 510 | ||
| DURABILITY | 511 | ||
| SUMMARY | 511 | ||
| REFERENCES | 512 | ||
| Care of the Postablation Patient | 515 | ||
| Key points | 515 | ||
| INTRODUCTION | 515 | ||
| ENDPOINTS FOR SURVEILLANCE | 516 | ||
| DURABILITY OF ENDOSCOPIC ERADICATION THERAPY AND RISK FACTORS FOR RECURRENCE | 518 | ||
| CURRENT GUIDELINES FOR SURVEILLANCE FOLLOWING ENDOSCOPIC ERADICATION THERAPY | 520 | ||
| TREATMENT OF RECURRENT DISEASE AFTER ENDOSCOPIC ERADICATION THERAPY | 520 | ||
| IMPORTANCE OF REFLUX CONTROL AND RISK FACTOR REDUCTION IN THE POSTABLATIVE SURVEILLANCE PERIOD | 521 | ||
| EMERGING MODALITIES FOR SURVEILLANCE | 521 | ||
| SUMMARY | 524 | ||
| REFERENCES | 525 | ||
| Esophagectomy for Superficial Esophageal Neoplasia | 531 | ||
| Key points | 531 | ||
| INTRODUCTION | 531 | ||
| LIMITATIONS OF ENDOSCOPIC THERAPIES: THE RISK OF NODAL METASTASES | 532 | ||
| Optimal Therapy for Superficial Submucosal Esophageal Carcinoma | 533 | ||
| LIMITATIONS OF ENDOSCOPIC THERAPIES: OTHER CONSIDERATIONS | 535 | ||
| ESOPHAGECTOMY FOR SUPERFICIAL ESOPHAGEAL NEOPLASIA: RATIONALE, TECHNIQUES, AND OUTCOMES | 537 | ||
| Rationale | 537 | ||
| Perioperative Mortality | 537 | ||
| Esophagectomy Techniques | 538 | ||
| Cure Rates | 539 | ||
| Quality of Life | 540 | ||
| Vagal-Sparing Esophagectomy | 540 | ||
| STUDIES COMPARING ENDOSCOPIC THERAPIES AND ESOPHAGECTOMY FOR SUPERFICIAL ESOPHAGEAL NEOPLASIA | 541 | ||
| SUMMARY | 541 | ||
| REFERENCES | 543 |