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

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 ¹.

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 ¹.