Outcome of endoscopy surveillance for Barrett's oesophagus

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dc.contributor.authorBright, T.
dc.contributor.authorSchloithe, A.
dc.contributor.authorBull, J.
dc.contributor.authorFraser, R.
dc.contributor.authorBampton, P.
dc.contributor.authorWatson, D.
dc.date.issued2009
dc.description.abstractEndoscopic surveillance of individuals with Barrett's oesophagus is undertaken to detect early stage oesophageal malignancy. The impact of a surveillance programme on endoscopy resources and disease detection is uncertain. Methods: In 2004, we commenced a structured Barrett's oesophagus surveillance programme. The surveillance protocol specifies surveillance interval and number of oesophageal biopsies required according to previous endoscopy and biopsy findings. The first 3 years of surveillance were reviewed to assess programme adherence, impact on endoscopy resources and the incidence of high-grade dysplasia and adenocarcinoma in patients undergoing surveillance. Results: Four hundred five patients were enrolled in the surveillance programme, and 776 patient years of endoscopy follow-up were analysed. Four-quadrant biopsies every 2 cm throughout the Barrett's oesophagus were performed in 89.8% of endoscopies. A total of 93.7% of patients had surveillance endoscopy performed at the appropriate time interval. Formalizing surveillance was followed by a decrease in the mean time interval for endoscopy surveillance from 16 months to 15 months, although the mode endoscopy surveillance interval lengthened from 1 year to 2 years. The mean number of biopsies per endoscopy increased from 5.9 to 7. In four patients, T1 stage oesophageal adenocarcinoma was identified, and in six patients, high-grade dysplasia was identified (combined incidence of adenocarcinoma/high-grade dysplasia 1 per 77.6 endoscopy years of follow-up). Conclusions: Structured Barrett's surveillance detects malignant progression at an early stage, which provides opportunities for curative surgical or endoscopic intervention. Formalizing surveillance resulted in a high rate of adherence to agreed guidelines and rationalized the use of endoscopy resources without significantly increasing workload.
dc.description.statementofresponsibilityTim Bright, Ann Schloithe, Jeff A. Bull, Robert J. Fraser, Peter Bampton and David I. Watson
dc.identifier.citationANZ Journal of Surgery, 2009; 2009(79):812-816
dc.identifier.doi10.1111/j.1445-2197.2009.05107.x
dc.identifier.issn1445-1433
dc.identifier.issn1445-2197
dc.identifier.urihttp://hdl.handle.net/2440/58376
dc.language.isoen
dc.publisherBlackwell Science Asia
dc.rights© 2009 The Authors Journal compilation © 2009 Royal Australasian College of Surgeons
dc.source.urihttps://doi.org/10.1111/j.1445-2197.2009.05107.x
dc.subjectBarrett's oesophagus
dc.subjectendoscopy
dc.subjectmalignancy
dc.subjectprotocol
dc.subjectsurveillance
dc.titleOutcome of endoscopy surveillance for Barrett's oesophagus
dc.typeJournal article
pubs.publication-statusPublished

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