Mechanical ablation includes: Endoscopic Mucosal Resection (EMR), and removing the area by biopsying it. EMR appears to be a reasonable option to esophagectomy in patients with high grade dysplasia or adenocarcinoma limited to the mucosa It appears logical to start the evaluation of a person with Barrett’s esophagus with a suspicious lesion (polyp, nodule, erosion and so on) or an already diagnosed adenocarcinoma with endoscopic ultrasound (EUS) This can help better define the target lesion and confirm that malignancy is limited to the mucosa. The next step would be to remove the target lesion by EMR (strip or suck methods) After EMR has eliminated the area of invasive cancer, the remainder of the dysplastic mucosa can be managed by less invasive ablative techniques like photodynamic therapy (PDT), argon plasma coagulation (APC) or multipolar electrocoagulation (MPEC)
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