Tag Archives: barrett’s esophagus

Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection: Minimally Invasive Techniques for Resecting GI Mucosal Tumors

Major advances in the development of endoscopic devices and techniques over the past fifteen years have introduced endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) as standard of care for the safe and effective removal and/or definitive staging of mucosal lesions of the esophagus, stomach, duodenum and colon, often eliminating major surgery as first-line management. Gastroenterologists at Penn State Hershey Medical Center including Abraham Mathew, M.D., Matthew Moyer, M.D., and Charles Dye, M.D., have become leading clinicians and active researchers in these techniques, performing several hundred EMR procedures annually. Mathew explains, “EMR is the more widely used of these techniques for removal of smaller tumors or lesions [<2.5 cm]. With EMR, normal saline or hydroxy propyl methylcellulose, dilute epinephrine and methylene blue are injected into key areas of the submucosal space beneath the tumor, strategically positioning the tumor and separating it from the bowel wall; the tumor can then be resected with less risk of thermal or mechanical damage to the muscularis propria. With ESD, a more aggressive technique for removal of larger, more invasive tumors, the surgeon uses specialized devices to tunnel into the submucosal plane to dissect the tumor en block. Incisions are closed endoscopically with sutures or clips.”

A colon mass lesion in the process of being resected by ESD.

Continue reading

Leave a comment

Filed under Treatments

Identifying Gene Expression Profiles Linked to Cancer Development in Barrett’s Esophagus

Douglas B. Stairs, Ph.D.

Douglas B. Stairs, Ph.D.

The rising incidence of Barrett’s esophagus (BE) over the past two decades, coincident with increases in obesity, chronic heartburn, and gastroesophageal reflux disease, has focused attention on questions about how to monitor and treat these patients. About four in 1,000 BE patients annually develop esophageal adenocarcinoma (EAC), a 30- to 40-fold greater risk than in the general public. EAC, in turn, is linked to five-year survival rates of only about 20 percent. While early identification of high-risk BE patients is critical to improve EAC survival, factors predictive of cancer progression have not been identified. Continue reading

Leave a comment

Filed under Disorders