Endoscopic mucosal resection of large hyperplastic polyps in 3 patients with Barrett's esophagus

World J Gastroenterol. 2006 Sep 21;12(35):5699-704. doi: 10.3748/wjg.v12.i35.5699.

Abstract

Aim: To report the endoscopic treatment of large hyperplastic polyps of the esophagus and esophago-gastric junction (EGJ) associated with Barrett's esophagus (BE) with low-grade dysplasia (LGD), by endoscopic mucosal resection (EMR).

Methods: Cap fitted EMR (EMR-C) was performed in 3 patients with hyperplastic-inflammatory polyps (HIPs) and BE.

Results: The polyps were successfully removed in the 3 patients. In two patients, with short segment BE (SSBE) (<= 3 cm), the metaplastic tissue was completely excised. A 2 cm circumferential EMR was performed in one patient with a polyp involving the whole EGJ. A simultaneous EMR-C of a BE-associated polypoid dysplastic lesion measuring 1 cm multiply 10 cm, was also carried out. In the two patients, histologic assessment detected LGD in BE. No complications occurred. Complete neosquamous re-epithelialization occurred in the two patients with SSBE. An esophageal recurrence occurred in the remaining one and was successfully retreated by EMR.

Conclusion: EMR-C appears to be a safe and effective method for treating benign esophageal mucosal lesions, allowing also the complete removal of SSBE.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Barrett Esophagus / complications
  • Barrett Esophagus / pathology
  • Barrett Esophagus / surgery*
  • Endoscopy, Gastrointestinal / methods*
  • Esophageal Diseases / pathology*
  • Esophageal Diseases / surgery*
  • Esophagogastric Junction / pathology
  • Esophagogastric Junction / surgery
  • Esophagus / pathology
  • Esophagus / surgery
  • Female
  • Humans
  • Hyperplasia / pathology
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Mucous Membrane / pathology
  • Mucous Membrane / surgery
  • Polyps / etiology
  • Polyps / pathology*
  • Polyps / surgery*