Division of General Surgery

Surgery for Barrett's Oesophagus

Barrett’s oesophagus is a rare condition in which the lining of the oesophagus, the tube carrying food from the mouth to the stomach changes and looks like the stomach lining. It is also mostly diagnosed in men older than 40 years. The cause for the Barrett’s oesophagus is not known but is commonly found in people with gastro-oesophageal reflux disease (GERD).But it does not show any symptoms. Thus people with GERD for a number of years should go for regular surveillance endoscopy and biopsies to detect Barrett’s oesophagus. This is very critical as Barrett’s oesophagus may often result in cancer of the oesophagus. Precancerous changes (dysplasia) if detected in the biopsy should be promptly treated to prevent the development of cancer.

Depending on the severity of the condition treatment may involve destroying or cutting-off the portion of the lining or removal of the most of the oesophagus through surgery.

Photodynamic therapy: In this the light-sensitizing agent is injected into a vein. Laser is then directed at the site through the endoscope to activate the light-sensitizing agent leading to destruction of the precancerous or cancerous cells in the oesophagus.

Endoscopic Mucosal Resection: When dysplasia or cancer involves only the top layer of the oesophagus the lining is lifted by injecting a solution under it or by suction and is then cut off through endoscope. Sometimes both PDT and EMR are used in combination for the treatment.

Surgery: It is done only in severe cases of dysplasia or cancer and usually involves cutting and removing most of the oesophagus and reconstructing it with the portion of the stomach.

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