Revisiting Barrett's Esophagus, 1st ed. 2019

This book focuses on Barrett?s Esophagus (BE), a clinical condition that must be evaluated in all patients affected by chronic GERD, and with an important link to esophageal cancer. Divided into four sections (morphological background, epidemiology and natural history, diagnosis, and treatments), this handy volume provides the latest indications regarding endoscopic approaches (first level and advanced endoscopy), pathological studies (pathology and molecular biology), and state-of-the-art therapeutic options (medical, endoscopic, and surgical) for BE. As such, it offers a valuable reference guide for all professionals involved in the management of BE (gastroenterologists, endoscopists, pathologists and surgeons), offering them a comprehensive overview and deeper understanding of this seemingly superficial disease. 

Part I Morphologic backgrounds

1 Macroscopic anatomy of esophagus

Stefania Montagnani, Clotilde Castaldo

2 Microscopic anatomy and histology of esophagus

Stefania Montagnani, Franca Di Meglio

3 Definition and epidemiology of Barrett’s esophagus

Alessandra Romiti, Rocco Maurizio Zagari

4 Pathophysiolgy of esophageal reflux disease and natural history of Barrett’s esophagus

Paola Iovino, Antonella Santonicola, Nigel J Trudgill

Gastro-esophageal reflux disease

Natural history of Barrett’s esophagus

Natural history of non dysplastic Barrett’s esophagus

Natural history of Barrett’s esophagus indefinite for dysplasia

Natural history of Barrett’s esophagus with low grade dysplasia

Natural history of Barrett’s esophagus with high grade dysplasia

5 Obesity: Barrett’s esophagus and esophageal cancer risk

Jan Marc Chevallier, Sonja Chiappetta, Mario Musella

Introduction

Factors leading to GERD

Obesity, Barrett’s ulcer, and risk of cancer

Bariatric surgery and risk of GERD

GERD following restrictive procedures

GERD following gastric by-pass procedures

Part III Diagnosis

6 First level endoscopy in Barrett’s esophagus: endoscopic pictures, Prague classification and biopsy protocols

Massimo Conio, Antonella De Ceglie, Mattia Crespi

Endoscopic pictures

Prague classification

Biopsy protocol

7 Augmented endoscopy in Barrett’s esophagus: zoom endoscopy, traditional, and virtual chromoendoscopy

Giuseppe Galloro, Raffaele Manta, Nico Pagano, Teresa Russo, Donato Alessandro Telesca, Andrea Parodi, Cesare Formisano

Introduction

Traditional chromoendoscopy

High definition, zoom, and magnifying endoscopy

Computed virtual chromoendoscopy

8 Confocal LASER endomicroscopy in Barrett’s esophagus: is it a clinical resource or still a research procedure?

Giovanni Domenico De Palma, Gianluca Cassese, Gaetano Luglio

Confocal LASER endomicroscopy: theoretical and practical bases

Technical notes

CLE for Barrett’s esophagus management

Current limitations and possibilities for future development

Conclusions

9 Histology: the different points of view on Barrett’s esophagus

Vincenzo Villanacci, Karel Geboes, Tiziana Salviato, Gabrio Bassotti

Normal esophagus

Endoscopic and microscopic diagnosis of Barrett’s esophagus

Is all intestinal metaplasia equivalent to Barrett’s esophagus?

Dysplasia in Barrett’s esophagus

10 The role of molecular biology in diagnosis and follow-up of Barrett’s esophagus

Karen Geboes, Anne Hoorens

Introduction

Molecular pathways implicated in development of Barrett’s esophagus

Molecular markers for the diagnosis

Markers for the diagnosis of dysplasia

Genome-wide association studies for the development of Barrett’s esophagus

Molecular pathways implicated in the transition of Barrett’s esophagus to early adenocarcinoma

Molecular biology of progression to adenocarcinoma

Molecular markers for the diagnosis of progression to EAC.

Genetic changes involved in the progression from BE to EAC. 

Biomarker development

Conclusions

11 Timing and protocols of clinical and endoscopic surveillance of Barrett’s esophagus

Carlo Calabrese, Marco Salice, Nico Pagano, Raffaele Manta, Fernando Rizzello

Protocol

Part IV Treatments

12 Lifestyles, medical therapy, and chemoprevention

Giancarlo Sarnelli, Alessandra D’Alessandro, Raf Bisschops

Physical activity and diet

Smoking and alcohol intake

Chemoprevention

13 Photodynamic therapy

Raffaele Manta, Dolores Sgambato, Nico Pagano, Giuseppe Galloro

Introduction

Technique

Data of literature

Limits

State of the art

14 Cryotherapy

Nico Pagano, Raffaele Manta, Giuseppe Galloro

Introduction

Physical principles and technical consideration

Clinical results

Conclusions

15 Endoscopic resections: EMR and ESD

Filippo Catalano, Seichiro Abe, Yutaka Saito

16 Radiofrequency ablation

Jason Samarasena, David Lee, Kenneth J Chang

Introduction

Indications

Equipment

Technique

Post procedure

Efficacy

Adverse events

Cost-effectiveness analysis

Buried Barrett’s Esophagus

Conclusions

17 What we have to do after the treatment of metaplasia or dysplasia in Barrett’s esophagus? Protocols and timing of follow-up in the treated patient

Jose Miguel Esteban

Introduction

Endoscopic therapies of Barrett’s esophagus

Surveillance after endoscopic therapy

Surveillance Strategies

Publications regarding Protocols and Timing for surveillance

Protocols and timing of follow-up in the treated patient recommendations

Special considerations

Conclusions

18 Is there a role for the surgeon in therapeutic management of Barrett esophagus?

Uberto Fumagalli Romario, Paul Magnus Schneider

Introduction

Does BE regress after ARS and/or does ARS reduce the cancer risk in BE?

Which type of surgery for short and long segment Barrett's esophagus ? 

Role of ARS to prevent BE recurrence or progression after endoscopic ablation procedures

19 Early adenocarcinoma in Barrett esophagus: is this an endoscopic or a surgical problem?

Antonello Trecca, Takuji Gotoda

After completing his medical school degree, Professor Giuseppe Galloro earned his post-graduate specialization in General Surgery, both with honors. Following his post-graduate training as a junior doctor at the General Surgery Department of the University of Naples Federico II - School of Medicine, he was appointed as assistant and then resident fellow at the same department. He later became a consultant at the Digestive Surgical Endoscopy Unit and Researcher in General Surgery. He was nominated as an Assistant Professor (2004) and Associated Professor (2015) of General Surgery at the University of Naples Federico II - School of Medicine, as well as head of the Diagnostic and Therapeutic Endoscopy of Non Neoplastic Diseases of the Digestive System, Biliary Tract and Pancreas Section at the same hospital. He currently teaches several graduate and post-graduate courses (on general surgery, digestive diseases, and digestive endoscopy). His main clinical and research practice is on new techniques and methodologies in diagnostic and operative endoscopy of pre neoplastic diseases and early digestive cancers; endoscopic management of obesity; computing applications and new materials applied to endoscopy. He has authored various volumes of congress proceedings, monographs and journal articles, and has been an invited speaker at over three hundred national and international congresses. 

All aspects of Barrett’s esophagus are illustrated and evaluated: from epidemiology and traditional approaches to augmented endoscopy, confocal endomicroscopy, timing and protocol of clinic and endoscopic surveillance, and new treatment options, including the latest for endoluminal anti-reflux surgery

Coherent layout throughout to facilitate easy reference

A broad international perspective provided by authoring team, all leading experts in the field