Addressing Controversies in the Management of Barrett’s Oesophagus Related Dysplasia

Abstract

Endoscopic mucosal resection (EMR) and radiofrequency ablation (RFA) are safe and effective for management of Barrett’s oesophagus with dysplasia; however, some patients have a poor response to RFA, and recurrence of dysplasia can occur. There are controversies surrounding the management of Barrett’s oesophagus with low grade dysplasia (LGD) due to the conflicting data in the literature on diagnosis and progression rate. This thesis describes the long-term outcomes of endoscopic eradication therapy in management of dysplastic Barrett’s oesophagus and factors associated with poor response to RFA. In addition, this thesis also addresses the wide range of progression rate of LGD in the literature, investigates the use of specific histologic criteria to predict progression from LGD and describes a different phenotype of LGD in Barrett’s oesophagus.