Diagnosis and Endoscopic Management of Barrett’s Esophagus: an Italian Experts’ Opinion based document

Costamagna, Guido; Battaglia, Giorgio; Repici, Alessandro; Fiocca, Roberto; Spada, Cristiano; Villanacci, Vincenzo

doi:10.1016/j.dld.2017.08.034

Cited by 6 publications

(2 citation statements)

References 56 publications

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“…Even though the 2012 ASGE guidelines suggested to consider endoscopic ablation for non-dysplastic BE in selected patients with higher risk of cancer [ 20 ], current guidelines do not recommend this practice [ 21 , 22 , 24 , 25 ] for several reasons including the low incidence of esophageal adenocarcinoma [ 28 ], the need of surveillance after ablation for the risk of buried metaplasia [ 29 ] and the lack of cost-effectiveness [ 30 ]. However, our results may be partially explained by an Italian position paper that suggested ablation therapy for non-dysplastic BE in selected cases [ 31 ]. Further research is needed evaluating benefits, risks and costs of this management strategy before it use in clinical practice.…”

Section: Discussionmentioning

confidence: 98%

Attending Training Courses on Barrett’s Esophagus Improves Adherence to Guidelines: A Survey from the Italian Society of Digestive Endoscopy

et al. 2020

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Background Little is known on practice patterns of endoscopists for the management of Barrett's esophagus (BE) over the last decade. Aims Our aim was to assess practice patterns of endoscopists for the diagnosis, surveillance and treatment of BE. Methods All members of the Italian Society of Digestive Endoscopy (SIED) were invited to participate to a questionnairebased survey. The questionnaire included questions on demographic and professional characteristics, and on diagnosis and management strategies for BE. Results Of the 883 SIED members, 259 (31.1%) completed the questionnaire. Of these, 73% were males, 42.9% had > 50 years of age and 68.7% practiced in community hospitals. The majority (82.9%) of participants stated to use the Prague classification; however 34.5% did not use the top of gastric folds to identify the gastro-esophageal junction (GEJ); only 51.4% used advanced endoscopy imaging routinely. Almost all respondents practiced endoscopic surveillance for non-dysplastic BE, but 43.7% performed eradication in selected cases and 30% practiced surveillance every 1-2 years. The majority of endoscopists managed low-grade dysplasia with surveillance (79.1%) and high-grade dysplasia with ablation (77.1%). Attending a training course on BE in the previous 5 years was significantly associated with the use of the Prague classification (OR 4.8, 95% CI 1.9-12.1), the top of gastric folds as landmark for the GEJ (OR 2.45, 95% CI 1.27-4.74) and advanced imaging endoscopic techniques (OR 3.33, 95% CI 1.53-7.29). Conclusions Practice patterns for management of BE among endoscopists are variable. Attending training courses on BE improves adherence to guidelines.

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Section: Discussionmentioning

confidence: 98%

Attending Training Courses on Barrett’s Esophagus Improves Adherence to Guidelines: A Survey from the Italian Society of Digestive Endoscopy

et al. 2020

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“…This definition is common to international guidelines 22-26 as well as Italian guidelines and expert statements 21 , 27 .…”

Section: Barrett’s Esophagusmentioning

confidence: 99%

Gastro-esophageal reflux disease and Barrett’s esophagus: an overview with an histologic diagnostic approach

et al. 2020

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Summary The first part of this overview on non-neoplastic esophagus is focused on gastro-esophageal reflux disease (GERD) and Barrett’s esophagus. In the last 20 years much has changed in histological approach to biopsies of patients with gastro-esophageal reflux disease. In particular, elementary histologic lesions have been well defined and modality of evaluation and grade are detailed, their sensitivity and specificity has been evaluated and their use has been validated by several authors. Also if there is not a clinical indication to perform biopsies in patient with GERD, the diagnosis of microscopic esophagitis, when biopsies are provided, can be performed by following simple rules for evaluation which allow pathologists to make the diagnosis with confidence. On the other hand, biopsies are required for the diagnosis of Barrett’s esophagus. This diagnosis is the synthesis of endoscopic picture (which has to be provided with the proper description on extent and with adequate biopsies number) and histologic pattern. The current guidelines and expert opinions for the correct management of these diagnosis are detailed.

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Histology: The Different Points of View on Barret’s Esophagus

Villanacci

Geboes

Salviato

et al. 2018

Revisiting Barrett's Esophagus

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Diagnosis and Endoscopic Management of Barrett’s Esophagus: an Italian Experts’ Opinion based document

Cited by 6 publications

References 56 publications

Attending Training Courses on Barrett’s Esophagus Improves Adherence to Guidelines: A Survey from the Italian Society of Digestive Endoscopy

Attending Training Courses on Barrett’s Esophagus Improves Adherence to Guidelines: A Survey from the Italian Society of Digestive Endoscopy

Gastro-esophageal reflux disease and Barrett’s esophagus: an overview with an histologic diagnostic approach

Histology: The Different Points of View on Barret’s Esophagus

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