barrett Flat Cancer Band Emr

                               
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This patient was referred for endoscopic treatment when surveillance biopsies found high grade dysplasia. On careful inspection, there is a nearly flat area of irregular mucosa on the anterior wall (left side of endoscopy screen) that is concerning for malignancy. Endoscopic resection is preferable to ablation in this situation because it is important to exclude submucosal invasive cancer (which is typically treated by surgical esophagectomy in the USA because of the risk of lymph node metastasis). Options for endoscopic resection include piecemeal EMR or ESD. Piecemeal EMR is fast to perform and technically easier than ESD.