PMID: 11901932Mar 21, 2002Paper

Endoscopy in Barrett's esophagus. Surveillance during reflux management and new advances in the diagnosis and early detection of dysplasia

Chest Surgery Clinics of North America
Jihad el Khoury, Anand V Sahai

Abstract

Given the alarming rise in the incidence of esophageal cancer and the fact that Barrett's esophagus is clearly a precursor to this disease, effective surveillance is desirable. Endoscopic surveillance is recommended by major endoscopic and gastrointestinal societies based on the available data and hypothetic models suggest that the costs of endoscopic surveillance for Barrett's esophagus may be reasonable when compared with other commonly applied cancer screening strategies. Although, however, most implicated physicians agree that surveillance is warranted, recommended guidelines often are not followed. This occurrence may reflect the importance of some of the practical limitations inherent to carrying out intensive endoscopic biopsy protocols in large numbers of eligible patients. In an effort to improve the surveillance process, several new techniques have been tested and are in development. These techniques are aimed at facilitating the histologic sampling of larger areas of metaplastic epithelium, at better targeting sites more likely to harbor dysplasia and cancer, and at replacing endoscopic biopsies with nonhistologic tissue analysis. Although many of these newer techniques are promising, however, none are currently clos...Continue Reading

References

Jun 27, 1997·Science·G J TearneyJ G Fujimoto
Oct 6, 1997·Gastroenterology Clinics of North America·A K Rustgi

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Citations

Aug 30, 2003·Journal of the American College of Surgeons·Renato RomagnoliMauro Salizzoni

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