Etiopathogenesis, diagnosis and treatment of Barrett's esophagus: modern views. Part 2

In the second part of the work, technological advances in endoscopic surgery are analyzed, which radically changed the treatment of dysplastic and early oncological diseases from aggressive to organ-preserving endoscopic treatment. A multimodal approach to treatment is shown, combining endoscopic resection of visible and/or protruding lesions with ablative methods for early forms of mucosal lesions in Barrett’s esophagus, followed by long-term follow-up, which improves the results of treatment of this nosological form. Safe and effective endoscopic treatment can be both tissue extraction, as with endoscopic resection of the mucous membrane with endoscopic submucous dissection, and tissue ablation, as with photodynamic therapy, radiofrequency stimulation and cryotherapy. It is shown that today the treatment of patients with Barrett’s esophagus consists of two main points: 1. Elimination of signs and manifestations of GERD; 2. Treatment of high-grade dysplasia and reduction of the risk of esophageal adenocarcinoma. It is noted that joint decision-making between the patient and the doctor is important when considering the treatment of dysplasia and Barrett’s esophagus.