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Korean J Gastroenterol  <  Volume 74(1); 2019 <  Articles

Korean J Gastroenterol 2019; 74(1): 11-16  https://doi.org/10.4166/kjg.2019.74.1.11
Diagnosis and Management of Barrett’s Esophagus, Dysplasia and Early Esophageal Adenocarcinoma: Focusing on American and European Guidelines
Ah Young Yoo and Moon Kyung Joo
Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
Correspondence to: Moon Kyung Joo, Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea. Tel: +82-2-2626-3007, Fax: +82-2-2626-1038, E-mail: latyrx@korea.ac.kr, ORCID: https://orcid.org/0000-0001-6050-3695
Received: June 7, 2019; Revised: June 19, 2019; Accepted: June 19, 2019; Published online: July 25, 2019.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Barrett’s esophagus (BE) is one of the most prominent diseases in Western countries because of its potential to progress to dysplasia or adenocarcinoma. Recently, the American College of Gastroenterology (ACG), American Gastroenterology Association (AGA), and European Society of Gastrointestinal Endoscopy (ESGE) developed clinical guidelines for the diagnosis and management of BE. All three guidelines commonly stressed the necessity of the endoscopic eradication of confirmed, nonnodular low grade dysplasia or high grade dysplasia, as well as the endoscopic elimination of the remaining BE after an endoscopic resection of visible mucosal abnormalities. An endoscopic resection is also considered for the optimal management of esophageal adenocarcinoma confined to the mucosa (T1a), and even in selective cases of submucosal invasion (T1b). As endoscopic therapy becomes the mainstay for the treatment of BE and its complications, the eligibility of pathologic or endoscopic experts and the BE expert center are being set and strengthened. This paper introduces the statements of the ACG, AGA and ESGE guidelines and compares the similarities and differences between them.
Keywords: Barrett esophagus; Esophageal neoplasms; Adenocarcinoma


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