How to manage HGD in Barrett Esophagus

How to manage HGD in patients with Barrett Esophagus

HGD is associated with 30% risk of developing EAC. If HGD is confirmed by an expert GI pathologist, there is currently no agreement on the most appropriate management of these patients. Treatment options available to patients include intensive endoscopic surveillance with four-quadrant biopsies every 1 cm performed every 3 months, endoscopic ablation therapy, or surgical resection. All of these treatment options have produced similar outcomes for patients in retrospective cohort studies performed at expert centers. Optimal treatment is therefore determined on a case-by-case basis, taking into account the patient’s age, comorbidities, and ability to comply with an aggressive surveillance program, as well as the available local endoscopic and surgical expertise.

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