When should I consider referring a patient with Barrett's oesophagus for surgical intervention?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Refer a patient with Barrett's oesophagus for surgical intervention, such as oesophagectomy, if they have stage 1 oesophageal adenocarcinoma (T1b) and are fit for surgery, especially in cases with high risk of cancer progression, such as incomplete endoscopic resection, evidence of lymphovascular invasion, or deep submucosal invasion (more than 500 microns) on histological examination of resection specimens .

Consider oesophagectomy for T1b oesophageal adenocarcinoma in patients who are fit for surgery and at high risk of cancer progression, including those with incomplete resection or adverse histological features .

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