Barrett-Ösophagus - Update zu klinischem Management und Therapien

Michael Quante, Julia Slotta Huspenina, Mohamed Abdelhafez

Publikation: Beitrag in FachzeitschriftArtikelBegutachtung

Abstract

Pathogenesis Adenocarcinomas of the esophagus are very similar to those of the stomach and most likely develop in the gastric cardia, from where proliferating cells expand into the esophagus and form benign Barrett's mucosa. An additional genomic instability leads to the clonal evolution of certain cells, which can lead to the development of adenocarcinoma. Risk factors A clear definition of factors is urgently needed for better risk stratification and the establishment of preventive strategies. Current prediction models, which include overweight, diet or tobacco consumption, have not yet been able to establish themselves in clinical application. Diagnostics and monitoring Current guidelines exist for diagnostics and monitoring. The diagnosis of Barrett's esophagus is performed histopathologically from 4-quadrant biopsies. In addition, macroscopically conspicuous areas of the Barrett mucosa should be biopsies. The detection of neoplastic areas can be improved by using chromoendoscopy in combination with magnification endoscopy and staining techniques (methylene blue or acetic acid). Therapy The curatively intended endoscopic resection is the standard therapy for dysplastic Barrett's metaplasia, mucosal (T1a m) and superficial submucosal (T1a sm1) adenocarcinoma. Here, cap and ligature resection as well as endoscopic submucosal dissection (ESD) represent the recommended resection techniques and, in combination with radiofrequency ablation, the therapy according to guidelines.

Titel in ÜbersetzungBarrett Esophagus - Update of clinical management and therapy options
OriginalspracheDeutsch
Seiten (von - bis)429-435
Seitenumfang7
FachzeitschriftDeutsche Medizinische Wochenschrift
Jahrgang145
Ausgabenummer7
DOIs
PublikationsstatusVeröffentlicht - 1 Apr. 2020
Extern publiziertJa

Schlagwörter

  • Barrett esophagus
  • ESD
  • esophageal carcinogenesis
  • risk factor

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