BCM
Gastroenterology Grand Rounds - Take Home Lessons
The main lessons to take home concerning this case
are:
1. Endoscopic ablative therapies for Barrett's esophagus
using laser thermal ablation or multipolar electrocoagulation have not
consistently reduced either dysplasia or the extent of Barrett's mucosa.
2. Photodynamic therapy either alone or in combination
with Nd:YAG laser thermal ablation along with long term acid inhibition
provides an effective endoscopic therapy to downgrade Barrett's mucosal
dysplasia and superficial esophageal cancer. However, complete elimination
of Barrett's is much more difficult to achieve.
3. Photodynamic therapy provides an effective palliative
treatment of advanced esophageal cancer to relieve dysphagia and improve
quality of life.
