Barrett's oesophagus with low-grade dysplasia is confirmed on two separate biopsies reviewed by an expert GI pathologist. Current guidelines (BSG/ASGE) recommend:
- A Radiofrequency ablation (RFA) or endoscopic eradication therapy is preferred to reduce progression risk, with continued high-dose PPI ✓
- B Oesophagectomy due to high progression risk to adenocarcinoma
- C Surveillance endoscopy alone every 6 months without ablation
- D Fundoplication surgery to prevent acid reflux and reverse dysplasia
Explanation
Confirmed low-grade dysplasia in Barrett's oesophagus carries an annual progression risk to high-grade dysplasia or adenocarcinoma of approximately 1–3% per year. Current BSG guidelines recommend endoscopic eradication therapy, preferably radiofrequency ablation (RFA), as the preferred intervention to reduce the risk of malignant progression. High-dose PPI is continued throughout. Oesophagectomy is disproportionate for LGD. Surveillance alone without ablation is no longer preferred when LGD is confirmed by expert review. Fundoplication treats GERD symptoms but does not reliably reverse established dysplasia.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.