Introduction and aims. In selected patients, endoscopic mucosal resection (EMR) is a valuable tool for diagnosis and treatment of Barrett's esophagus (BE). Currently, there is few available information regarding the reclassification of histological diagnosis in BE associated focal lesions. The aim was to evaluate the reclassification of histological diagnosis post-EMR, in patients with BE with biopsy proven dysplasia. Material and methods. This is a retrospective and descriptive study. We included patients with BE from January 2002-december 2013, in whom EMR was performed and had a previous biopsy with either low grade dysplasia (LGD), high grade dysplasia (HGD) or intramucosal carcinoma (IMC).EMR was performed by either the cap technique or by using the multi-band ligator technique. Results. We analyzed 41 specimens obtained in 19 EMR procedures performed in 11 patients. When pre and post-EMR diagnosis were evaluated, there was a reclassification in histological diagnosis in 7 of 11 (63%) patients (downstaging occurred in 5 and upstaging occurred in 2 patients). The global follow-up time was 45 (3-95) months. Nine patients (81.8%) received endoscopic eradication therapy without recurrence in the follow up. There were no procedure related complications. Conclusions. EMR conditions a significant change in histological diagnosis in BE with dysplasia patients.

A benefit of enteral nutritional support over the parenteral for acute and chronic diseases has been observed because it is more physiological and is associated with fewer complications. The most frequently used for this purpose are nasoenterals feeding tubes lasting no more than 30 days and percutaneous accesses involving longterm feeding. Prepiloric feeding is appropriate for most critical patients. However, postpiloric feeding, which is achieved with nasojejunal probes, percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) and jejunostomy is indicated for those with regurgitation, aspiration of gastric foods or presence of leaks in the upper tractodigestive. There are several methods for the placement of enteral accesses, the endoscopic being the first choice in most cases, leaving the one performed by radiointervention and surgical for the technically difficult cases. There are advances with new endoscopic techniques such as endoscopic percutaneous jejunostomy by double balloon enteroscopy (PEJ) and endoscopic ultrasound in pacemakers with modified anatomy (Y-Roux) and excluded stomach, as well as the placement of selfexpanding metal prostheses at the duodenal or gastrojejunostomy by endoscopic ultrasound assisted by fluoroscopy guided by double balloon intestinal occlusion in cases of obstruction to the outflow tract by neoplasia. Due to the above, based on patient characteristics and prognosis, there are already more endoscopic options to preserve the enteral route as the main nutritional route in patients with chronic diseases.