Esophagectomy for eosinophilic esophagitis: how to avoid it

Patients with eosinophilic esophagitis (EoE) can currently benefit from an evidence-based medical and dietary treatment according to knowledge accumulated from observational studies and randomized controlled trials, the results of which were summarized in several systematic reviews and meta-analyses. Surgery is relegated to solving some uncommon complications of EoE and has been exclusively applied in a handful of cases of esophageal perforation. This letter to the editor criticizes the only case of elective esophagectomy carried out in a 27-year-old male with EoE and longstanding dysphagia, which was unresponsive to obstinate endoscopy-based treatment. Despite medical and dietary treatment, strategies in EoE must still be improved and basing the clinical management of sufferers on the application of therapies with demonstrated effectiveness instead of empirical strategies is highly desirable.