New minimally-invasive surgical technique for esophageal high-grade dysplasia and Barrett's esophagus

"The Frantzides Technique" -- a New Treatment for Esophageal High-Grade Dysplasia and Barrett's Esophagus

Constantine Frantzides M.D., Ph.D., F.A.C.S., Director of the Chicago Institute of Minimally Invasive Surgery, staff surgeon and Director of the Laparoscopic Fellowship Program at Saint Francis Hospital, has pioneered a new minimally-invasive surgical technique for the treatment of Barrett's esophagus and high-grade dysplasia.  

The technique called "Laparoscopic Transgastric Esophageal Mucosal Resection" or "Frantzides Technique" entails the "stripping" of the internal lining of the esophagus (mucosa) that carries the pre-cancerous lesion. This minimally-invasive technique is a major advancement because it offers patients an alternative to traditional surgery which removes the esophagus entirely, or to endoscopic procedures that examine and remove abnormal segments of the esophageal mucosa but may miss an underlying malignancy.  

"Any time you can develop a technique that is minimally-invasive and cures a disease that otherwise would require major open surgery, it is a win-win situation," says Dr. Frantzides.

Dr. Frantzides and his colleagues reported the minimally-invasive technique and the outcomes in the August 2010 issue of the American Journal of Surgery (Volume 200, Number 2).  This is noted as the first report to describe the outcomes of this procedure.  Patients were followed between four (4) to seven (7) years and did not experience a recurrence of dysplasia.  The "Frantzides Technique" can also be combined with an anti-reflux procedure to prevent gastroesophageal reflux which is the cause of Barrett's and high-grade dysplasia.

Patients who are candidates for this surgery include individuals who have precancerous Barrett's esophagus with high-grade dysplasia that result from gastroesophageal reflux disease (GERD).

Gastroesophageal reflux disease (GERD-heartburn) is known to be the cause of Barrett's esophagus which can ultimately lead to esophageal cancer.  The risk of esophageal cancer developing in a patient with uncomplicated Barrett's esophagus is relatively low.  However, if the Barrett's esophagus is complicated by high-grade dysplasia then the risk of cancer increases about ten-fold.  

According to the National Cancer Institute (NCI) the incidence of esophageal cancer, which is associated with Barrett's esophagus, is rising in the United States.  The American Cancer Society estimates that during 2009 approximately 16,470 new esophageal cancer cases were diagnosed in the United States.  

SOURCE Saint Francis Hospital