Copyright ©The Author(s) 2019.
World J Gastrointest Endosc. Oct 16, 2019; 11(10): 491-503
Published online Oct 16, 2019. doi: 10.4253/wjge.v11.i10.491
Table 1 Summary of the history and role of all endoscopic therapies
EMREMR was introduced in Japan to treat early gastric cancer and its use in esophagus was first reported by Inoue in 1990[14]. EMR use determines local stage, degree of differentiation and lymphovascular invasion[15]EMR is indicated to remove sessile, flat or discrete mucosal lesions < 2  cm in size and involving less than two-thirds of the circumference of esophageal wall[14] Focal EMR is removal of visible lesions only. Stepwise radical EMR is removal of entire Barrett’s segment in single or multiple sessions
ESDESD was introduced in 1988 in Japan to treat gastric cancer and subsequently, its use was extended to treat superficial esophageal cancer[17]ESD is indicated for en-bloc resection of lesions irrespective of the size. ESD is a technically demanding and time consuming procedure
STERSTER was introduced in 2011 and is based on the principles of peroral endoscopic myotomy and ESD[21]STER is used to resect submucosal tumors[21]. The advantage of STER is preservation of mucosal integrity that lowers adverse outcomes[23]
RFARFA was introduced in 2005 and is now a well-established modality for early esophageal cancer which utilizes high frequency alternating electrical current to generate thermal energy for ablation[25]RFA is the standard of care in flat mucosal lesions[25]. In RFA, a circumferential catheter is used to ablate ≥ 3 cm Barrett’s segment or a focal catheter for shorter segments
PDTPDT was one of the first techniques described for treatment of Barrett’s associated neoplasiaPDT is associated with many complications and is not commonly used in the United States any more
CryotherapyCryotherapy was introduced in 1851 by James Arnott to freeze tumors[27]. The application of Cryotherapy was extended to the esophagus in 1997 using an endoscopeCryotherapy circumvents the need for mucosal contact making ablation of an uneven or nodular surface feasible[27]. CbFAS uses cryogenic fluid and overcomes the challenges of unequal distribution and need for decompression tube
Hybrid-APCAPC was introduced in the early 1990s to perform thermal coagulation of tissue[25]. More recently, Hybrid APC in which a submucosal cushion is created before APC is being used[28]Hybrid APC is indicated in Barrett’s esophagus up to 3-5 cm in length and the cushion controls the depth of ablation[28]