Endoscopic Therapy

The U-M Division of Gastroenterolgy has a long experience with endoscopic eradication therapy for neoplastic Barrett's esophagus, starting with yttrium aluminum garnet (YAG) laser ablative therapy in the 1990s. The first endoscopic mucosal resection was performed in 2005 and radiofrequency ablation soon after. In addition, we now offer endoscopic therapies for achalasia. The Esophageal Disorders Program currently has six endoscopists providing esophageal endoscopic therapy.

Barrett's esophagus eradication therapies

Endoscopic mucosal resection (EMR)
  • U-M has performed over 300 EMR procedures.
  • Low complication rates:
    • Stricture formation – 25%, resolved with 1 dilation in 94%.
    • Bleeding – 1.5%
    • Perforation – 0.2%
Radiofrequency ablation (RFA)
  • U-M has performed over 200 RFA procedures
    • Bleeding – 1.3%
CryoSpray ablation  

Achalasia therapies

Pneumatic dilation
  • either fluoroscopically guided or with EndoFLIP, avoiding radiation exposure
Per oral endoscopic myotomy (POEM)  
Botulinum toxin (Botox®) injection