Surgical treatment of dysplasia and adenocarcinoma.

It is currently recommended that patients with Barrett's esophagus who are medically fit be enrolled in a surveillance program and undergo 1 to 2 yearly endoscopy examinations with multiple biopsies. An acceptable protocol for these purposes requires obtaining four biopsy specimens, one from each quadrant of the esophagus, every 2 cm along the visible length of the Barrett's mucosa, with additional biopsy specimens from any abnormal-appearing area. Patients in surveillance programs are directed for further therapy if they develop low-grade or high-grade dysplasia or invasive adenocarcinoma.