[Barrett esophagus and Barrett carcinoma].

The incidence of Barrett carcinoma has increased almost six-fold in the last 20 years. Barrett oesophagus is defined as the presence of metaplastic columnar epithelium in the oesophagus in continuity with the gastric mucosa. It is regarded as an acquired abnormality, developed as a result of chronic (duodenal) gastro-oesophageal reflux. It is especially the intestinal type of columnar epithelium that has a greatly enhanced risk of malignant degeneration. It is advisable that patients with a Barrett oesophagus should regularly be examined endoscopically, with extensive tissue biopsy. Presence of Barrett epithelium without dysplasia or with only moderate dysplasia does not in itself constitute an indication for supplementary treatment. Major dysplasia constitutes an indication for prophylactic resection. In the treatment with curative intention of Barrett carcinoma, surgery is the therapy of first choice.