What is the recommended treatment for Barrett's esophagus with high-grade dysplasia?

Barrett's esophagus is a condition where the normal squamous lining of the esophagus is replaced by columnar epithelium due to chronic gastroesophageal reflux disease (GERD). High-grade dysplasia in this context indicates significant cellular abnormalities that are associated with an increased risk of progression to esophageal adenocarcinoma.

The recommended treatment for Barrett's esophagus with high-grade dysplasia is esophagectomy. This surgical procedure involves the removal of the esophagus and is considered a curative approach because it eliminates the dysplastic tissue and significantly reduces the risk of developing esophageal cancer. Esophagectomy is especially indicated in patients who are good surgical candidates, as it addresses not only the dysplasia but also the underlying condition contributing to Barrett's esophagus.

In contrast, endoscopic surveillance and medications for reflux are more appropriate for Barrett's esophagus without dysplasia or low-grade dysplasia, where the risk of cancer is lower and where surveillance can help monitor progression. Observation only is not appropriate when high-grade dysplasia is present due to the potential for rapid progression to malignancy. Hence, the definitive approach for high-grade dysplasia in Barrett's esophagus is esophagectomy, as it aims to remove the affected area and mitigate the