Barrett's esophagus (BE) with high‐grade dysplasia (HGD) has previously been a routine indication for esophagectomy. Recent advances in endoscopic therapy have resulted in a shift away from surgery. Current international guidelines recommend endoscopic therapy for BE with HGD irrespective of recurrence or progression of dysplasia. Current guidelines do not address the ongoing role of esophagectomy as an adjunct in the setting of failed endoscopic therapy. This review examines the role of esophagectomy as an adjunct to endoscopy in the management of patients with BE and HGD, with a specific focus on patients with persistent, progressive, or recurrent disease, disease resistant to endoscopic therapy, in patients with concomitant esophageal pathology, and in those patients in whom lifelong surveillance may not be possible or desired.

中文翻译：

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食管切除术在 Barrett 食管高度异型增生治疗中的作用

Barrett 食管 (BE) 与高度不典型增生 (HGD) 以前一直是食管切除术的常规指征。内窥镜治疗的最新进展导致了手术的转变。目前的国际指南推荐内镜治疗 BE 和 HGD，而不管异型增生的复发或进展。目前的指南没有解决食管切除术作为内镜治疗失败的辅助手段的持续作用。本综述探讨了食管切除术作为内窥镜辅助治疗在 BE 和 HGD 患者中的作用，特别关注持续性、进行性或复发性疾病、对内镜治疗有抵抗力的患者，以及伴有食管病理学的患者，以及那些可能无法或不希望进行终生监测的患者。