In Barrett's esophagus with confirmed high-grade dysplasia (HGD), the current recommended management according to British Society of Gastroenterology (BSG) guidelines is:

• A Oesophagectomy within 3 months of diagnosis
• B Radiofrequency ablation (RFA) or endoscopic mucosal resection (EMR) for visible lesions followed by RFA ✓
• C High-dose PPI therapy with repeat endoscopy at 3 months
• D Photodynamic therapy as first-line treatment

Explanation

Current BSG and ESGE guidelines recommend endoscopic therapy as the standard of care for Barrett's esophagus with HGD or early esophageal adenocarcinoma (T1a): any visible lesion should be resected by EMR/ESD for histological staging, followed by ablation of the residual flat Barrett's segment using radiofrequency ablation (RFA) to achieve complete eradication of intestinal metaplasia. Surgery is reserved for T1b (submucosal) disease with high-risk features or after failed endoscopic therapy. Photodynamic therapy has been superseded by RFA due to superior safety and efficacy.

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.