A Randomized, Prospective Cross-Over Trial Comparing Methylene Blue-Directed Biopsy and Conventional Random Biopsy for Detecting Intestinal Metaplasia and Dysplasia in Barrett’s Esophagus

Ragunath, Krish; Krasner, N; Raman, Vinod; Haqqani, M T; Cheung, Winson Y.

doi:10.1055/s-2003-44599

Cited by 88 publications

(49 citation statements)

References 12 publications

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“…The method by which methylene blue is applied and the degree of mucus clearing performed prior to application of the methylene blue affects this technique (65). Studies have had mixed results and prospective crossover studies have not found a clear advantage to methylene blue chromoscopy in comparison to random four quadrant biopsies in detection of dysplasia (66)(67)(68). Other contrast agents such as crystal violet, indigo carmine, and acetic acid have also been proposed to enhance the detection of mucosal patterns in Barrett's esophagus in combination with high resolution endoscopy (69).…”

Section: Imaging In Barrett's Esophagusmentioning

confidence: 99%

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Sampliner

2008

The American Journal of Gastroenterology

1,280

893

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PREAMBLEThe guidelines for the diagnosis, surveillance and therapy of Barrett's esophagus were originally published by the American College of Gastroenterology in 1998 and updated in 2002. These and other guidelines undergo periodic review. Significant advances have occurred in the area of Barrett's esophagus over the past four years leading to another revision of the prior guidelines. These advances include the potential use of esophageal capsule endoscopy for the diagnosis and screening of Barrett's esophagus, data regarding the outcome of low-grade dysplasia, the treatment of high-grade dysplasia using photodynamic therapy, and the development of new ablation techniques such as radiofrequency ablation. These guidelines are intended to be applied by physicians who see Barrett's esophagus patients and are intended to indicate a preferred, but certainly not the only, acceptable approach. Physicians need to choose the course best suited to the individual patient and to the variables that exist at the time of decision making. The guidelines are for adult patients with the diagnosis of Barrett's esophagus, as defined herein.Both these and the original guidelines were developed under auspices of the American College of Gastroenterology and the Practice Parameters Committee and approved by the Board of Trustees. The world literature was reviewed extensively for the original guidelines and once again reviewed using the National Library of Medicine database. Search terms used included Barrett's esophagus, esophageal neoplasm, esophagus, intestinal metaplasia, esophageal diseases, and adenocarcinoma, all appropriate studies and any additional ones found in reference to these papers were obtained and reviewed. Evidence was available from a hierarchy of trials and randomized controlled trials were given the greatest weight. Abstracts presented at national and international meetings were only used when unique data from ongoing trials were presented. When scientific data were lacking, recommendations are based on expert opinion. The recommendations made are based on the level of evidence found. Grade A recommendations imply that there is consistent level 1 evidence (randomized controlled trials), Grade B indicates that the evidence would be level 2 or 3 which are cohort studies or case control studies. Grade C recommendations are based on level 4 studies meaning case series or poor quality cohort studies, and Grade D recommendations are based on level 5 evidence meaning expert opinion.

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Section: Imaging In Barrett's Esophagusmentioning

confidence: 99%

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Sampliner

2008

The American Journal of Gastroenterology

1,280

893

View full text Add to dashboard Cite

show abstract

“…Methylene blue is the most commonly used and is actively absorbed by the mucosa with IM. Some studies have shown that this method has a higher diagnostic accuracy for the diagnosis of IM with a lower number of biopsies needed compared to fourquadrant random biopsies (38,39). However, some other studies have found that the use of methylene blue is not superior to WLE with random biopsies for the diagnosis of IM or dysplasia (40).…”

Section: Diagnosis Of Bementioning

confidence: 99%

Optimizing the diagnosis and therapy of Barrett’s esophagus

2017

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“…De allí surge la posibilidad de someter a estos pacientes a ablación con argón plasma por vía endoscópica para disminuir este riesgo de desarrollar un adenocarcinoma [1][2][3][4][5] . Recientemente se ha descrito la restauración parcial de la mucosa escamosa después de la ablación de EB con técnicas endoscópicas 6,7 .…”

Section: Seguimiento Endoscópico E Histológico Post Ablación Con Argóunclassified

Seguimiento Endoscópico E Histológico Post Ablación Con Argón Plasma Del Esófago De Barrett Extenso en Pacientes Sometidos a Tratamiento Quirúrgico Previo

Valladares

et al. 2014

Rev Chil Cir

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Argon plasma ablation of extensive Barrett esophagus. Experience in 19 patientsBackground: Endoscopic argon plasma ablation of Barrett esophagus decreases the risk of future esophageal cancer development. aim: To assess the endoscopic regression of columnar epithelium and the presence of intestinal metaplasia among patients operated for Barrett esophagus and subjected to argon plasma ablation. Patients and methods: In 19 patients with extensive Barrett esophagus subjected to a nissen fundoplication, Barrett esophagus was endoscopically ablated with argon plasma. Patients were assessed 6 and 12 months after surgery to evaluate the regression of columnar epithelium and the presence of intestinal metaplasia. results: One, two and three ablation sessions were carried out in 10, three and six patients, respectively. Three patients had complications. The initial length of columnar epithelium segment was 52 ± 15.6 mm and decreased to 22.6 ± 10.6 mm (p < 0.05). In 12 patients, there was absence of intestinal metaplasia on follow up, in six it persisted (one of them with "buried cells") and in one patient, dysplasia appeared. conclusions: Endoscopic argon plasma ablation may have a complementary therapeutic role for the regression of columnar epithelium in Barrett esophagus.

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A Randomized, Prospective Cross-Over Trial Comparing Methylene Blue-Directed Biopsy and Conventional Random Biopsy for Detecting Intestinal Metaplasia and Dysplasia in Barrett’s Esophagus

Cited by 88 publications

References 12 publications

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus

Optimizing the diagnosis and therapy of Barrett’s esophagus

Seguimiento Endoscópico E Histológico Post Ablación Con Argón Plasma Del Esófago De Barrett Extenso en Pacientes Sometidos a Tratamiento Quirúrgico Previo

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