Diagnóstico, seguimiento y tratamiento endoscópico del esófago de Barrett

María Elena López Acosta; Gonzalo Rodríguez Vanegas; Alberto Farca Belsaguy; Guillermo de la Mora Levy; Felipe Presenda Miller; Alberto González Angulo

2001, Número 2

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Rev Mex Cir Endoscop 2001; 2 (2)

Diagnóstico, seguimiento y tratamiento endoscópico del esófago de Barrett

López AME, Rodríguez VG, Farca BA, Mora LG, Presenda MF, González AA

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Idioma: Español
Referencias bibliográficas: 67
Paginas: 52-62
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RESUMEN

Se reconoce al esófago de Barrett (EB) como una entidad pre maligna del adenocarcinoma (AC), y complicación del reflujo gastroesofágico, sin embargo existen diferentes opiniones en cuanto al diagnóstico endoscópico, vigilancia y tratamiento. En esta revisión se analizan técnicas nuevas de detección endoscópica, el seguimiento y el protocolo de estudio al encontrar displasia o adenocarcinoma in situ, así como la indicación, eficacia y seguridad de diferentes tratamientos endoscópicos. ¿Por qué no todos los pacientes con reflujo gastroesofágico desarrollan esófago de Barrett? ¿Cuál es la incidencia de esófago de Barrett de segmento corto? ¿Es suficiente la terapia antirreflujo adecuada -médica o quirúrgica- para impedir la evolución a adenocarcinoma? ¿Qué vigilancia de acuerdo a costo beneficio debe llevar un paciente con EB? ¿Es una realidad la ablación y reepitelización con células escamosas mediante algún método? ¿Existen biomarcadores capaces de predecir grupos de mayor riesgo de evolución a adenocarcinoma? ¿Qué tratamiento es el más adecuado en caso de displasia severa y en adenocarcinoma temprano? Son todos temas aún controversiales que se exponen a continuación.

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