{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:27:58Z","timestamp":1792841278567,"version":"4.5.0"},"reference-count":182,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2023,12]]},"abstract":"Main Recommendations<\/jats:title>\n MR1\u2002ESGE recommends the following standards for Barrett esophagus (BE) surveillance:<\/jats:p>\n \u2013 a minimum of 1-minute inspection time per cm of BE length during a surveillance endoscopy<\/jats:p>\n \u2013 photodocumentation of landmarks, the BE segment including one picture per cm of BE length, and the esophagogastric junction in retroflexed position, and any visible lesions<\/jats:p>\n \u2013 use of the Prague and (for visible lesions) Paris classification<\/jats:p>\n \u2013 collection of biopsies from all visible abnormalities (if present), followed by random four-quadrant biopsies for every 2-cm BE length.<\/jats:p>\n Strong recommendation, weak quality of evidence.<\/jats:p>\n MR2\u2002ESGE suggests varying surveillance intervals for different BE lengths. For BE with a maximum extent of \u2265\u200a1\u200acm and <\u200a3\u200acm, BE surveillance should be repeated every 5 years. For BE with a maximum extent of \u2265\u200a3\u200acm and <\u200a10\u200acm, the interval for endoscopic surveillance should be 3 years. Patients with BE with a maximum extent of \u2265\u200a10\u200acm should be referred to a BE expert center for surveillance endoscopies. For patients with an irregular Z-line\/columnar-lined esophagus of <\u200a1\u200acm, no routine biopsies or endoscopic surveillance are advised.<\/jats:p>\n Weak recommendation, low quality of evidence.<\/jats:p>\n MR3\u2002ESGE suggests that, if a patient has reached 75 years of age at the time of the last surveillance endoscopy and\/or the patient\u2019s life expectancy is less than 5 years, the discontinuation of further surveillance endoscopies can be considered. Weak recommendation, very low quality of evidence.<\/jats:p>\n MR4\u2002ESGE recommends offering endoscopic eradication therapy using ablation to patients with BE and low grade dysplasia (LGD) on at least two separate endoscopies, both confirmed by a second experienced pathologist.<\/jats:p>\n Strong recommendation, high level of evidence.<\/jats:p>\n MR5\u2002ESGE recommends endoscopic ablation treatment for BE with confirmed high grade dysplasia (HGD) without visible lesions, to prevent progression to invasive cancer.<\/jats:p>\n Strong recommendation, high level of evidence.<\/jats:p>\n MR6\u2002ESGE recommends offering complete eradication of all remaining Barrett epithelium by ablation after endoscopic resection of visible abnormalities containing any degree of dysplasia or esophageal adenocarcinoma (EAC).<\/jats:p>\n Strong recommendation, moderate quality of evidence.<\/jats:p>\n MR7\u2002ESGE recommends endoscopic resection as curative treatment for T1a Barrett\u2019s cancer with well\/moderate differentiation and no signs of lymphovascular invasion.<\/jats:p>\n Strong recommendation, high level of evidence.<\/jats:p>\n MR8\u2002ESGE suggests that low risk submucosal (T1b) EAC (i.\u200ae. submucosal invasion depth \u2264\u200a500\u200a\u00b5m AND no [lympho]vascular invasion AND no poor tumor differentiation) can be treated by endoscopic resection, provided that adequate follow-up with gastroscopy, endoscopic ultrasound (EUS), and computed tomography (CT)\/positrion emission tomography-computed tomography (PET-CT) is performed in expert centers.<\/jats:p>\n Weak recommendation, low quality of evidence.<\/jats:p>\n MR9\u2002ESGE suggests that submucosal (T1b) esophageal adenocarcinoma with deep submucosal invasion (tumor invasion >\u200a500\u200a\u00b5m into the submucosa), and\/or (lympho)vascular invasion, and\/or a poor tumor differentiation should be considered high risk. Complete staging and consideration of additional treatments (chemotherapy and\/or radiotherapy and\/or surgery) or strict endoscopic follow-up should be undertaken on an individual basis in a multidisciplinary discussion.<\/jats:p>\n Strong recommendation, low quality of evidence.<\/jats:p>\n MR10\u2002a ESGE recommends that the first endoscopic follow-up after successful endoscopic eradication therapy (EET) of BE is performed in an expert center.<\/jats:p>\n Strong recommendation, very low quality of evidence.<\/jats:p>\n b\u2002ESGE recommends careful inspection of the neo-squamocolumnar junction and neo-squamous epithelium with high definition white-light endoscopy and virtual chromoendoscopy during post-EET surveillance, to detect recurrent dysplasia.<\/jats:p>\n Strong recommendation, very low level of evidence.<\/jats:p>\n c\u2002ESGE recommends against routine four-quadrant biopsies of neo-squamous epithelium after successful EET of BE.<\/jats:p>\n Strong recommendation, low level of evidence.<\/jats:p>\n d\u2002ESGE suggests, after successful EET, obtaining four-quadrant random biopsies just distal to a normal-appearing neo-squamocolumnar junction to detect dysplasia in the absence of visible lesions.<\/jats:p>\n Weak recommendation, low level of evidence.<\/jats:p>\n e\u2002ESGE recommends targeted biopsies are obtained where there is a suspicion of recurrent BE in the tubular esophagus, or where there are visible lesions suspicious for dysplasia.<\/jats:p>\n Strong recommendation, very low level of evidence.<\/jats:p>\n MR11\u2002After successful EET, ESGE recommends the following surveillance intervals:<\/jats:p>\n \u2013 For patients with a baseline diagnosis of HGD or EAC:at 1, 2, 3, 4, 5, 7, and 10 years after last treatment, after which surveillance may be stopped.<\/jats:p>\n \u2013 For patients with a baseline diagnosis of LGD:at 1, 3, and 5 years after last treatment, after which surveillance may be stopped.Strong recommendation, low quality of evidence.<\/jats:p>","DOI":"10.1055\/a-2176-2440","type":"journal-article","created":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T19:17:56Z","timestamp":1696879076000},"page":"1124-1146","source":"Crossref","is-referenced-by-count":217,"title":["Diagnosis and management of Barrett esophagus: European Society of Gastrointestinal Endoscopy (ESGE) Guideline"],"prefix":"10.1055","volume":"55","author":[{"given":"Bas L. 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