Clinical management and endoscopic therapy in Barrett's esophagus

In patients with histologically proven Barrett's esophagus, surveillance endoscopy should be done. Patients with short-segment Barrett's esophagus should be scheduled for endoscopy every 4 years and those with long-segment Barrett's esophagus every 3 years. Besides the routinely performed quadrant biopsies, chromoendoscopy could be helpful to detect subtle early neoplasia. Because long Barrett's neoplasia is limited to the mucosal layer, endoscopic therapy should be the treatment of choice. Endoscopic resection should always be favored over photodynamic therapy or thermal ablative methods because it is the only endoscopic treatment method providing exact information about the infiltration depth of the neoplastic lesion.