Barrett Esophagus , advanced endoscopy for early diagnosis of dysplasia and esophageal cancer
Channel: Orhan TARÇIN
Date: 25/01/2022

Esophageal Cancer Precursor "Dysplasia" 
Advanced Endoscopy 
Dear viewers, today I'd like to talk about Barrett’s esophagus. Barrett's esophagus is the progression of the inner membrane of the stomach into the esophagus. This happens especially in patients with reflux disease, but sometimes deterioration can occur at the lower end of the esophagus before the inner membrane of the stomach progresses into the esophagus. We can only detect this with advanced endoscopes,  which can perform chromoendoscopy and magnify the lesion nearly 200 hundert times(microscopic endoscopy)                                                                                                                                                                                                                                                                                                                                                                                  .+
Of course, when we examine with normal endoscopes, we only get a red image, but advanced endoscopes, which there are only a few of them in Turkey, currently reveal both the micro vascular structure and the microartchitecture  (burada gönderdiğim seslendirmede bu düzeltme –yani mikromimari yok , önemli değil seslendirmede olmasada olur.) magnifying  them and by painting with light. And micro- vascular structures allow us to diagnose early-stage cancer or catch it in the previous stage before progressing into  cancer.
Now, as you can see here, every time we enter a patient, we always examine the lower end of the esophagus. During the examination of our patient, we found nothing in normal imaging, but when we put it into BLI mode, we also saw a minimal esophagitis after zooming --. So, the acid went up, it looked like it was burning. But after we washed this area, we also realized that after magnification and switching to special Blue Laser Imaging (BLI) mode, there is cell degradation in an area of about 2.5 millimeters, and this is not metaplasia. So, it's not a cell change. It is dyplasia. So, it's the  stage before cancer.
As you can  see, there is the appearance of honeycombs here at the junction of   the normal esophagus and the inner membrane of the stomach. It differs from top to bottom, left to right and surrounding tissues with a diameter of 2.5 millimeters. This is the tissue with low levels of dysplasia. And that tissue you see is the inner membrane of the esophagus. This is how we examine the inner membrane of the esophagus with advanced endoscopy. If there is one deterioration of the vascular structures here, there is early-stage cancer. As you can see here again.
Yes, this time we are examining it with a mode called LCI mode, we are magnifying it, and as you can see, red areas, problematic areas, areas where dysplasia is present. We paint with Lugol’s solution. Because there may also be a problem at the lower end of the esophagus. Painting the lower end of the esophagus or esophagus with Lugol’s solution is a good option and may also reveal early-stage tumors. As a result, if you suspect, examine your patient very carefully. In particular, it is necessary to examine the junctional area of the esophagus with the stomach very well. Especially in high-risk patients. As you can see in this patient, there was a lesion that could develop into early-stage cancer, which we call dysplasia, and that's where we caught it. As a result of the resection of this point, the patient is free of this disease. #Barrett #dysplasia #esophagus