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Barrett’s Oesophagus

Barrett’s Oesophagus

TEN

A non-invasive treatment for Barrett’s Oesophagus is now

available at London Bridge Hospital, which is changing

the way dysplasia and very early cancer is treated.

Barrett’s Oesophagus is a pre-cancerous condition associated with gastro-oesophageal

reflux disease and central obesity. It is estimated that 13% of people who have

chronic acid reflux also have Barrett’s Oesophagus. Men develop Barrett’s

Oesophagus twice as often as women, and Caucasian men are affected more

often than men of other races. It carries a low, but unpredictable risk of

progression to oesophageal cancer. When dysplasia is present, the risk of

cancer is considered high enough to warrant treatment

to remove the affected Barrett’s mucosa. This was,

until recently, treated with major surgery. Now,

new minimally invasive endoscopic techniques

allow the removal of the abnormal Barrett’s

mucosa without the need for surgery. This

can either be achieved by Radiofrequency

Ablation (RFA) alone, or in combination

with Endoscopic Mucosal Resection (EMR).

The RFA technique uses an electrode

mounted either on a balloon or endoscope,

and enables the endoscopist to destroy

the lining of the oesophagus by tissue

vaporisation. Once the abnormal Barrett’s lining

is removed, the mucosa that regrows is usually

normal squamous lining. A number of studies have

demonstrated that RFA safely results in a high rate

of complete eradication of Barrett’s Oesophagus, as

well as reducing progression of the disease to cancer.

The EMR technique uses a snare device to remove areas within

the Barrett’s Oesophagus lining which are raised or depressed,

and thus suspicious for cancer. The benefit of EMR is that large

biopsy specimens can be removed to render the lining flat. The

disadvantage of this treatment is that use of EMR for widespread

Barrett’s Oesophagus has a high rate of strictures. Therefore, focal

EMR for specific areas of concern has usually been followed two

months later by RFA to safely and effectively remove the remainder

of the Barrett’s Oesophagus.

New endoscopic

treatments for

Barrett’s Oesophagus

For more information on our Endoscopic Services, please contact the GP Liaison Department on:

T: 020 7234 2009