Journal
BEST PRACTICE & RESEARCH CLINICAL GASTROENTEROLOGY
Volume 29, Issue 1, Pages 97-111Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.bpg.2014.11.011
Keywords
Barrett's oesophagus; Early neoplasia; Surveillance; Advanced imaging techniques
Categories
Funding
- Olympus Endoscopy
- Cook Medical
- Boston Scientific
- GI Solutions Covidien
- Erbe
- Ninepoint Medical
Ask authors/readers for more resources
Evaluation of patients with Barrett's oesophagus (BO) using dye-based chromoendoscopy, optical chromoendoscopy, auto-fluorescence imaging, or confocal laser endomicroscopy does not significantly increase the number of patients with a diagnosis of early neoplasia compared with high-definition white light endoscopy (HD-WLE) with random biopsy analysis. These newer imaging techniques are not more effective in standard surveillance of patients with BO because the prevalence of early neoplasia is low and HD-WLE with random biopsy analysis detects most cases of neoplasia. The evaluation and treatment of patients with BO and early-stage neoplasia should be centralized in tertiary referral centers, where procedures are performed under optimal conditions, by expert endoscopists. Lesions that require resection are almost always detected by HD-WLE, although advanced imaging techniques can detect additional flat lesions. However, these are of limited clinical significance because they are effectively eradicated by ablation therapy. No endoscopic imaging technique can reliably assess submucosal or lymphangio-invasion. Endoscopic resection of early-stage neoplasia in patients with BO is important for staging and management. Optical chromoendoscopy can also be used to evaluate lesions before endoscopic resection and in follow-up after successful ablation therapy. (C) 2014 Elsevier Ltd. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available