Video Endoscopic Sequence 10 of 13.
Mechanical ablation includes: Endoscopic Mucosal Resection (EMR), and removing the area by biopsying it.
EMR appears to be a reasonable option to esophagectomy
in patients with high grade dysplasia or adenocarcinoma
limited to the mucosa It appears logical to start the
evaluation of a person with Barrett’s esophagus with a
suspicious lesion (polyp, nodule, erosion and so on) or an
already diagnosed adenocarcinoma with endoscopic
ultrasound (EUS). This can help better define the target
lesion and confirm that malignancy is limited to the mucosa.
The next step would be to remove the target lesion by
EMR (strip or suck methods).
After EMR has eliminated the area of invasive cancer, the
remainder of the dysplastic mucosa can be managed by
less invasive ablative techniques like photodynamic
therapy (PDT), argon plasma coagulation (APC) or
multipolar electrocoagulation (MPEC).